Le blessé médullaire : de la phase préhospitalière à la réhabilitation

The diagnosis of an unstable spinal cord injury is sometimes difficult. A missed injury may have devastating long-term consequences. Spinal cord injury commonly occurs in young men after a traffic road accident. The neurological prognostic is dependent on pre-hospital care. Hypotension, related to haemorrhage and/or vasoplegia, and hypoxaemia may worsen neurological damage. A complete initial check up is mandatory according to a severity score established by the American Spinal Injury Association (ASIA). The delay to surgery is planned according to the severity of the neurological deficit. No other treatment has been demonstrated to be effective so far. Many patients with quadriplegia or high-paraplegia have a long-term outcome, even if they need the support of controlled ventilated. The aim of the rehabilitation process is to improve patient's autonomy.