The management of traumatic spinal cord injury (SCI) requires thorough neurologic assessment and injury classification to guide treatment as well as inform prognosis. Initial radiographic evaluation is aimed at efficiently determining spinal column stability and should begin with high-quality multislice helical computed tomography imaging, including coronal and sagittal reconstructions. The primary objective of clinical SCI management is to prevent or ameliorate secondary injury caused by cardiovascular instability and/or pulmonary insufficiency, in addition to other comorbid processes common to this disease. Vigilant monitoring and treatment in the critical care setting is one of the most important means of reducing morbidity and mortality following SCI.