Abstract
The thoracic spine and lumbar spine are the most frequent sites of fracture. The presence of spinal cord injury (SCI) must be assumed in all polytrauma patients until proven otherwise. For this reason, the cervical collar should be placed in all polytrauma patients until SCI is ruled out. Tingling or paralysis of a limb suggests severe injury to the spinal cord. Rectal examination is an essential part of the neurological examination and should assess anal sphincter tone, anal and perianal sensitivity, and anal and bulbocavernosus reflexes. In contrast to spinal shock, which is a transient reflex depression of cord function below the level of injury, neurogenic shock is characterized by hypotension and bradycardia resulting from the loss of vasomotor tone and sympathetic innervation to the heart. Paraplegia and quadriplegia from SCI can be either complete or incomplete. Recent studies have demonstrated the lack of efficacy of high-dose methylprednisolone in the acute treatment of patients with spinal cord injuries.