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From the Guest Editor
With the new millennium promising more exacting and less invasive treatment options, improved outcomes, minimized risks, and other cost effective benefit, spine specialists must constantly assess and re-assess the validity of their treatment indications both from the standpoint of what strategies are available today and what might be available in the future. Treatment options of tomorrow may be preferable to what is available today. Timing of surgery is very important. The new millennium ushers in exciting possibilities in the field of medicine. Care of the back, neck, and spinal cord represents a $17 billion financial expenditure annually in the US. When lost economic gain is considered estimates as high as $34 to $52 billion are reality. These ailments affect virtually everyone at some point in their lives. Yet our understanding and ability to help these people is only now beginning to offer the outcomes that treatment of other common ailments have yielded. CNI will play an integral role in its proactive endeavor to remain at the forefront of offering comprehensive multi-disciplinary treatment to those with neurologic disease. Of significant impact is the recent establishment of the CNI Acute Spinal Cord Injury Service. This Service will integrate its efforts seamlessly with Craig Hospital so those patients with acute spinal cord injury are afforded the most up-to-date cutting edge acute spinal cord injury management. By appropriately treating the acute stages of spinal cord injury, the extension of the penumbra zone is minimized. Therefore, the delayed sequelae of such injury can be minimized and rehabilitative prognosis can be maximized. Furthermore, with efforts focused on finding cures for paralysis, patients with the most effective acute management will hopefully find themselves the most suitable candidates for future treatment modalities.
Brian Wieder, MD
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CNI REVIEW Library · CNI PublicationsColorado Neurological Institute (CNI),
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The new millennium brings with it extraordinary advances and innovations in
the treatments available to those with spine and spinal cord disease. Molecular,
cellular, recombinant and transplantation strategies that
were unimaginable several years ago are now opening windows into emerging
treatment strategies for paralysis, other sequelae of spinal cord injury, and
the regeneration of disc and ligamentous structures in this decade. Advances in
prosthetic spinal implants and minimally invasive techniques are rapidly
replacing traditional surgical approaches. Greater understanding of the
biomechanical, physiologic, and neurologic nuances of spine and spinal cord
disease and its treatments have lead to specialized training in the complexities
of spinal and spinal cord surgery. Improved neuro-imaging capabilities have
enabled the exacting placement of implants via computer assisted or robotic
protocols. Magnetic Resonance capabilities will assess the histochemical
signature of spinal cord lesions preempting the need for dangerous invasive
biopsy. The emergence of the field of spine surgery as a distinct specialty
within the auspices of orthopedic and neurological surgery may be reality within
the next 5 years. As our understanding of the etiology, and treatment of spinal
pathology grows, the distinct treatment philosophies proprietary to the various
subspecialties, mainly physical therapy, chiropractic, orthopedic, and
neurological surgeons, will unify the various multi-disciplinary viewpoints.
Treatment strategies across interdisciplinary fields will converge rather than
diverge.
