History of Clinical Services, Medical Training, and Research for Spinal Cord Injuries and Disorders in the United States Veterans Health Administration

As of August 2025, the Veterans Health Administration (VHA) Spinal Cord Injuries and Disorders (SCI/D) system of care provides state-of-the-art specialty medical care for 24,560 United States Veterans living with SCI/D and multiple sclerosis and motor neuron disease with spinal cord involvement. This article reviews the history of VHA SCI/D care to show how VHA's early adoption of rehabilitation innovations and lifetime management not only improved Veterans' outcomes but also contributed to its evolution as a world leader in SCI/D research, training, and comprehensive life-long care. This review traces events that shaped the current VHA SCI/D System of Care as it evolved from housing and pensions for disabled Veterans after the US Civil War to the present-day foundational service within one of the largest health care, research, and medical training systems in the world.This history highlights VHA's longstanding commitment to providing comprehensive, world-class services for Veterans and their families and reinforces its leadership and commitment to cutting-edge research on treatments, potential SCI/D cures, and innovations in precision medicine, training, and technology for all people living with SCI/D.