The most important sequela of injuries to the spinal column is damage to the spinal cord. There are an estimated 10,000 new cases of spinal cord injury each year, rendering approximately 5000 people quadriplegic.1 In addition to the personal tragedy, tremendous financial costs are involved in the care of the spinal cord-injured patient. In 1996, the costs during the first year after a spinal cord injury located from C1 through C4 averaged $417,000. Lifetime medical costs were estimated at $1,350,000 for the same patients.1 The estimated annual cost of medical, rehabilitative, and vocational care for all spinal cord-injured patients in the United States is $2 to 4 billion.2

Injuries to the spinal cord are due to blunt trauma in about 90 percent of cases. The most common injury mechanism is a motor vehicle accident, followed by assaults—mostly gunshot wounds, falls, and sporting accidents.1 The cervical spine is the most common site for injury to the spinal cord (61 percent), followed by the thoracolumbar junction (19 percent), the thoracic spine (16 percent), and the lumbosacral spine (4 percent). 3

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