Abstract
I INTRODUCTION
Traumatic spinal cord injury afflicts more than 8000 new patients per year (1). This
figure will tend to increase over time as improved methods of transportation, lifesupport, and trauma care will allow for greater survival rates from high-energy trauma.
The evaluation and management of patients with spinal injury are often complicated
because it typically occurs in the context of polytrauma. In addition, the level of
complexity in rehabilitating these patients is increased by the functional limitations
placed upon the patient as a result of neurological injury. The most important part of
the treatment of a patient with spinal cord injury begins with the initial assessment.
The careful evaluation and clear documentation of the patient’s neurological status will
allow the treating physician to best decide the appropriate initial treatment as well as
to determine the prognosis for functional recovery and the long-term rehabilitation
goals for each individual. This chapter will focus on the physical examination of the
patient with spinal cord injury, with emphasis on the recommendations made by the
American Spinal Injury Association (ASIA). It will also describe the various spinal
cord syndromes that may be encountered by the treating physician.