There is currently a lack of consensus on the optimal approach to several areas of SCI diagnosis and treatment, in part owing to heterogeneity in injuries (cervical versus thoracic, complete versus incomplete) but also owing to conflicting interpretations of the literature. Early recognition and appropriate triage of patients are critical first-line components of care; however, the choice of imaging modalities for diagnosis and prognostication remains unclear . Care is largely supportive, but the long-term importance of early surgical decompression (<24 hours), blood pressure augmentation (mean arterial pressure [MAP] ≥85 mmHg) and selective use of methylprednisolone (MPSS) is increasingly being recognized. Even under ideal circumstances, recovery of lost function is patient dependent and largely determined by their clinical status at 1–2 years post-injury