The care of the patient with quadriplegia secondary to cord damage has not yet reached a level comparable to that given other patients with severe paralysis. Because injury to the cervical spinal cord results in such devastating loss, a defeatist attitude of helplessness and hopelessness all too often pervades this type of care. However, a fairly high degree of independence and self-sufficiency is possible for most patients if a program based on preserving all remaining function is begun early.
The principles of treatment are not difficult to put into practice. There are two major considerations: (1) to prevent the added damage of decubiti, contractures, and further neurological loss, and (2) to make maximum use of residual function.
The first concern is the prevention of further neurological trauma. Since the origin of the brachial plexus is in the cervical area, any progression of spinal-cord or root damage results in loss of