I would like to start by quoting some literature.
“The idea of giving spinal cord sufferers a comprehensive treatment and care from the start and throughout all stages is now more and more universally recognized, as against the customary approach of fragmentation of the initial and early treatment of these patients to their social rehabilitation, erronously called “Third Phase” of management. In this respect, the congregation of paraplegics and tetraplegics in Spinal Centres under the care of a specialized staff has proved beyond all doubt to be the best basis for such comprehensive management of these most severely disabled victims of accidents and disease, and consequently the idea of setting up Spinal Injuries Centres, …., is now spreading all over the world… One can point to progress in many directions, but some of the more outstanding may be mentioned here: the participation of the isolated cord through co-ordinated reflexes in the restoration and maintenance of the upright position of the paralysed, reorientation of postural and vasomotor control by special methods, prevention and treatment of pressure sores and infection of the urinary tract in the immediate and later stages, restoration of the respiratory function in tetraplegics and a new approach to the sexual problems. Our findings of the highly significant role played by autonomic mechanisms, especially the cardio-vascular system, in the function of the organisms below and above the transection of the spinal cord have opened new vistas into future research. Ways have been revealed in which the dysfunction of internal organs in the paralysed part of the body excite abnormal discharge of the various components of the autonomic system and also how the autonomic hyperreflexia can be controlled and avoided.” Sir Ludwig Guttmann 1973.
