Spinal cord injuries (SCIs) may be potentially devastating and cause widespread changes for the injured person and his/her surroundings. The handling and treatment of these injuries may either aggravate, or improve the functional outcome for the patient. The general idea is that early onset rehabilitation is an advantage with respect to regaining function. Several different health care professions are engaged in the treatment chain, and a wide range of frameworks and technologies govern the decision making along the way.
In Norway, the majority of SCI patients are treated at Ullevål and Sunnås hospitals. By interviewing health care professionals, studying manuals and frameworks and by following patients I have become familiar with the treatment chain of SCIs. Earlier, the idea was to initiate rehabilitative efforts almost immediately upon arrival at Ullevål, but resources have not been allocated accordingly. The transfer of patients from primary care and into a more rehabilitative mode must be balanced against assuring vital functions. Furthermore, this transfer is often either delayed, in which case lack of rehabilitation efforts may impede functional recovery, or done prematurely which may cause admittance to a local intensive care unit. Either way, resources are employed sub-optimally.
The incidence rate of SCIs in Norway is about 100. By using established life expectancy figures and cost estimates for the various categories of SCIs, there is sufficient data to justify further investments in facilities, personnel and routines to assure increased functional gain from early rehabilitation efforts.