Neglected traumatic spinal cord injuries: experience sharing from Pakistan

I have read ‘Neglected traumatic spinal cord injuries: causes, consequences and outcomes in an Indian setting’ by Chhabra and Arora¹ with interest. They have highlighted a problem regarding the management of traumatic spinal cord injury (TSCI) in India, which I believe holds true for most of the developing regions of the world. Spinal cord injury (SCI) management and rehabilitation in most of the low resourced regions of the world is inadequate. There are concerns about the pre-hospital management,^{2, 3} lack of advanced imaging studies,⁴ inadequate access to specialized surgical care, high cost of spinal surgery⁵ and lack of comprehensive SCI rehabilitation.²

Neglected SCIs are encountered in Pakistan as well, although they have not been reported in the medical literature. I would like to present two unusual cases of neglected-TSCI from Pakistan, which were seen during my visit to the mountainous terrain of Balakot in June 2008 as part of the community-based rehabilitation program for the TSCI survivors of 2005 earthquake.

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