Purpose of review: This article provides an overview of acute spinal cord injury with an emphasis on practical issues regarding initial evaluation and management. Spinal cord injury continues to be a devastating neurologic injury and a significant public health burden, both in terms of patient morbidity as well as societal costs. Optimal management is highly dependent on a strong multidisciplinary and interprofessional collaborative approach.
Recent findings: In contrast to prior experience, current guidelines strongly suggest avoidance of steroids in patients with spinal cord injury. Additionally, early evaluation with MRI and decompressive surgery can be important for achieving good outcomes.
Summary: Effective management of acute spinal cord injury requires a team skilled in the approach to short- and long-term respiratory management as well as vigilance for common secondary complications including systemic thrombosis, infection, and pain syndromes.