Spinal injury usually involves a fracture of the spinal column, which sometimes leads to spinal cord injury. The main causes of spinal injury are road traffic collisions, falls, violent attacks, sporting injuries and domestic incidents. Although spinal injury affects all ages, young and middle‑aged men and older women tend to be the populations at highest risk. Approximately 1000 people sustain a new spinal cord injury each year in the UK. These injuries are associated with serious neurological damage and can result in paraplegia, tetraplegia or death. Currently there are no 'cures' for spinal cord injury and in the UK there are 40,000 people living with long‑term disabilities as a result of such injuries.

This guideline covers the assessment, imaging and early management of people (adults and children) with spinal column or spinal cord injury secondary to a traumatic event. It includes the following key clinical areas:

  • initial triage and management by pre‑hospital care staff

  • acute stage clinical assessment and management

  • acute stage imaging

  • timing of referral and the criteria for acceptance by tertiary services

  • information and support needs of patients and their families and carers

  • documentation

  • training and skills.

The guideline does not cover spinal injury that is caused by a disease, rather than a traumatic event.