The aim of this study was to determine whether there have been epidemiologic changes in acute spinal cord injury. Two groups of patients injured in the same geographic area were compared: the first group of 351 patients was injured between 1947 and 1973; and the second group of 201 patients between 1974 and 1981. The results showed that there were indeed major epidemiologic changes in spinal cord injury between the two study periods. Most importantly, the more recently injured group were younger, arrived sooner, had less severe cord injuries, and higher frequencies of motor vehicle, and sports and recreational accidents, but fewer work-related injuries.