Paralysis is one of the most devastating complication of spine injuries .In developing world road traffic accidents are one of the major cause of spine injuries while in the developing world fall injuries followed by road traffic accidents constitute a major chunk of these patients While primary injury to the spinal cord and nerve tissues happens at the time of accident ,particular care should be taken while managing the patient at the site of accident as well as proper immobilization and proper transportation of the patient to the centers dealing with such trauma, with the basic aim being to prevent further injury to the spinal cord. Ideally patient should be shifted to advanced trauma management center as soon as possible .If the patient reaches trauma center or hospital within eight hours of accident ,high dose steroid therapy should be started and if general condition of the patient permits ,in unstable injuries, operative stabilization should be done as soon as possible. Basic purpose of such of such surgery being earliest possible rehabilitation of the patient and providing better environment around spinal cord for neural recovery to take place by removing pressure of displaced bony fragments and soft tissues on spinal tissue. However it should be clear that neural recovery is never the aim of the surgery as in majority of the cases with complete paralysis, permanent injury to the spinal cord has already taken place at the time of accident.

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