Abstract
Summery Over the past 6 decades, the general principles of management of acutely injured spinal cord patients have been defined. The physiological alterations and special characteristics of acute spinal cord injury were also recognised. The arguments in favour or against surgical intervention, Is ultimately aimed at arriving at an optimal management of these devastating injuries. Since there is no specific treatment to repair an injured spinal cord, all the emphasis is concentrated on prevention of further (secondary) injury whether it might be bio-mechanical or patho-physiological, concerns about the first i.e. biomechanical instability, lead to overemphasis on the benefit of surgical intervention, sometimes, without the support of specialist comprehensive care of the patho-physiological instability and multi-system dysfunction associated with spinal cord injury.