Advances in the Rehabilitation of the Spinal Cord–Injured Patient

The Orthopaedic Surgeons' Perspective

Brian K. Kwon, MD, PhD, FRCSC; Dan Banaszek, MD, FRCSC; Steven Kirshblum, MD


J Am Acad Orthop Surg. 2019;27(21):e945-e953. 

In This Article

Abstract and Introduction


Acute traumatic spinal cord injury is a devastating condition affecting 17,700 new patients per year in the United States alone. Typically, orthopaedic surgeons focus on managing the acute surgical aspects of care (eg, surgical spinal decompression and stabilization). However, in the care of these patients, being familiar with how to prognosticate neurologic recovery and manage secondary complications is extremely important. In addition, as anintegral part of the multidisciplinary care team, the surgeon should have an awareness of contemporary rehabilitation approaches to maximize function and facilitate reintegration into the community. The purpose of this review article is to provide a surgeon's perspective on these aspects of spinal cord injury care.


When encountering patients with acute spinal cord injury (SCI), the orthopaedic surgeon is typically focused on the acute surgical management of the injury, which includes the initial trauma resuscitation, hemodynamic management, surgical decompression/stabilization, and early postoperative care. Aside from these issues, the surgeon is also frequently faced with questions about neurologic prognosis and is typically part of a multidisciplinary team that manages acute secondary complications and subsequent rehabilitation. This review focuses on a practical overview of these topics from the perspective of the treating orthopaedic surgeon.