Evolution of spinal cord injury treatment in military neurosurgery.

During the mid-1900s, military medicine made historical advancements in the diagnosis, stabilization, and treatment of spinal cord injuries (SCIs). In particular, World War II was an inflection point for clinical practice related to SCIs because of the vast number of devastating injuries to soldiers seen during World War I (WWI). The unprecedented rate of SCI along with growth in the field served as a catalyst for surgical and interdisciplinary advancements through the increased exposure to this challenging pathology. Initially, a tragic fate was assumed for soldiers with SCIs in WWI resulting in a very conservative approach strategy given a multitude of factors. However, soldiers with similar injuries 20 years later saw improved outcomes with more aggressive management interventions by specialists in spine trauma, who applied measures such as spinal traction, arthrodesis, and internal fixation, and with the significant developments in the complex rehabilitation of these patients. This article describes the historical shift in the management of SCIs through the two world wars. These historical lessons of SCI and the fundamental advances in their neurosurgical intervention have molded not only military but also modern civilian treatment of SCI.

The overlooked heroines: three Silver Star nurses of World War I.

As members of forward-deployed combat hospitals, World War I Army nurses Miss Jane Rignel, Miss Linnie Leckrone, and Miss Irene Robar received the Citation Star for gallantry in attending to the wounded while under artillery fire in the month of July 1918. In 1932, they were authorized to exchange their Citation Stars for the new Silver Star Medal. Nursing in the war was difficult and required caring for patients exposed to chemical weapons and trauma while in harsh field conditions. These women were among the many Army nurses decorated for their performance in World War I.

Medical support for Pershing's Punitive Expedition in Mexico, 1916-1917.

Pershing's Punitive Expedition had adequate medical support despite deliberately limited in-theater resources. The few casualties did not strain the inadequate number of forward providers. Preventive medicine was highly successful due to significant medical and command emphasis. New technologies were useful and helped minimize the medical footprint. National Guard troops mobilized to support the Expedition had troublesome medical readiness rates.