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A spinal cord injury only ceased being a mortal condition in the mid-1940s. Sir Ludwig Guttmann, who pioneered rehabilitation for people with spinal cord injuries, was given the brief to establish a spinal unit at Stoke Mandeville Hospital in England in preparation for the D-Day landings. Guttmann invented nothing new, but effectively challenged the attitude and assumption that nothing could be done for people with spinal cord injuries. Up until then, over 90 per cent of people died within the first year post injury. He systematically assessed patients’ needs and worked back from causes of mortality to the introduction of life-maintaining procedures. For example, many people died from septicaemia as a consequence of acquiring pressure sores. To prevent pressure sores, patients need to be turned. With nursing staff, Guttmann organised a very strict regime of turning, which reduced the frequency of pressure sores. This model of rehabilitation was emulated in North America and other spinal centres within the UK and Guttmann’s early work has provided a blueprint for the comprehensive rehabilitation of people with spinal cord injuries (Guttmann, 1976).
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