Edaravone Attenuates ACSL4-Dependent Ferroptosis in Spinal Motor Neurons Following Cardiac Arrest in Rats.

Although rare, sports-related spine injuries can result in devastating, life-altering consequences, with the cervical spine injury being the most common with potentially devastating consequences, including quadriplegia and immediate death from cardiopulmonary compromise. Sports remain a leading cause of spinal cord injury (SCI) in the first 3 decades of life. Early, appropriate on-field management is critical to prevent further harm and improve outcomes. This manuscript outlines current evidence-based best practices for sideline evaluation and management of athletes with suspected spine injuries. Assessing and managing airway, breathing, and circulation (ABCs) as needed, along with minimizing spinal motion, are critical components of effective on-field emergency management. Rapid and accurate injury severity assessment is essential to guide the appropriate emergency response. Thorough preplanning and training are also vital to ensuring effective on-field management. Numerous practical considerations such as criteria for immobilization, helmet and shoulder pad removal, and transfer techniques are discussed.

Spinal lesions in athletes can be classified into overuse and acute injuries. Overuse injuries can be found after repetitive spinal load during sport activity; acute trauma injuries of the spine are common in contact sports. We present an overview of the wide spectrum of spinal injuries related to sport activity and review their imaging findings. Concerning overuse injuries, we focus on degenerative spine disease, spondylolysis, pedicle fractures, apophyseal ring injuries, Schmorl's nodes, and Scheuermann's disease. Acute spinal injuries are relatively frequently reported in athletes and may be the reason for severe morbidity. Similar to the general population, the type of acute spine fracture in athletes depends on the specific trauma mechanism.

BackgroundAccurate prediction of functional recovery after thoracolumbar fracture with incomplete spinal cord injury (SCI) remains challenging. We aimed to identify independent predictors and develop a validated model for 12-month functional outcome.MethodsIn this single-center, retrospective cohort study (January 2018–December 2024), consecutive adults (≥18 years) with acute T11-L2 fractures and admission American Spinal Injury Association Impairment Scale (AIS) grade B, C, or D were enrolled. Functional recovery was defined as ≥1 AIS grade improvement plus ≥10-point Spinal Cord Independence Measure version III (SCIM-III) gain at 12 months. Candidate predictors (n = 23) were selected a priori based on literature review and expert consensus. Missing data (<8% per variable) were multiply imputed (m = 20). Multivariable logistic regression with Firth’s correction and backward elimination guided by Akaike Information Criterion was used. Model discrimination [optimism-corrected area under the curve (AUC) 0.87] and calibration (Hosmer-Lemeshow test) were assessed by 1,000 bootstrap resamples. Pre-specified subgroup analyses examined age, AIS grade, surgical timing and lesion length.ResultsAmong 1,032 eligible patients, 206 (20.0%) achieved functional recovery. Eight predictors were independently associated: admission AIS grade (OR 4.5 per grade, 95% CI 3.5–5.8), motor score (OR 1.05 per point, 1.03–1.07), intact posterior ligamentous complex (OR 2.3, 1.6–3.2), decompression ≤ 24 h (OR 1.9, 1.4–2.7), non-smoking (OR 1.7, 1.2–2.4), Charlson Comorbidity Index = 0 (OR 1.5, 1.1–2.1), shorter intramedullary T2 lesion length (OR 0.96 per mm, 0.95–0.97) and rehabilitation intensity ≥3 h/day (OR 1.4, 1.0–1.9). The final model demonstrated an optimism—corrected AUC of 0.87 (95% CI: 0.85–0.89) and calibration characteristics with a calibration slope of 1.02, an intercept of 0.01, and a Hosmer–Lemeshow p-value of 0.18 during internal validation. Predictive effects were stronger in younger, AIS B/C patients and when surgery was performed early.ConclusionA parsimonious eight-factor model showed robust discrimination and satisfactory calibration in internal validation for 12-month functional recovery after thoracolumbar incomplete SCI, enabling individualized prognostication. External validation in independent multicenter cohorts is required before clinical implementation and treatment decision-making.

Background:Traumatic spinal cord injury is one of the most crucial causes of male infertility worldwide. Present study investigated the impact of acute spinal cord contusion injury on the structure and function of both blood testis barrier and blood epididymal barrier and highlighting the role of both inflammatory and autoimmune responses in post-traumatic possible infertility. Materials and Methods: Animals were divided into Sham group: laminectomy was performed to 15 male rats but without spinal cord injury. Experimental group: laminectomy was performed to another 15 male rats. A contusion injury of spinal cord was performed by 8 gm weight drop with one second dwell.Animals were sacrificed; testis and epididymis samples were prepared for histological and immunohistochemical examination. Results: Histopathological results revealed profound change in both testicular and epididymal epithelium, evident gaps were detected between basal and adluminal compartments of seminefrous tubules; apoptotic changes appeared in Sertoli cells with loss of ectoplasmic specialization inside their cytoplasm.The lining principal cells appeared vacuolated with pyknotic neuclei and evident loss to their sterocillia and tight junction. Immunohistochemical results revealed an increased expression of the proinflammatory cytokine IL1β in the experimental group. Moreover, disrupted integrity of both blood testis barrier and blood epididymal barriers was confirmed by decreased expression of occludin protein at the lateral borders and apices of lining epithelial cells. Autoimmune response was detected by increased expression of the green fluorescent labeled IgG immune complexes in experimental group. Conclusion: Acute spinal cord contusion injury affects the process of spermatogenesis via disruption of both blood testis barrier and blood epididymal barrier.

ABSTRACTBackgroundIntervertebral disc degeneration (IVDD) is a major cause of global disability that increases with age. IVD age may affect its injury susceptibility, yet few studies examine spine biomechanical changes with age, fewer address multiple injury types, and none investigate the interplay between age and injury.MethodsAn ex vivo mouse lumbar spine biomechanical study to determine the effects of age, injury, and their interaction. IVDs of 4, 12, and 24 months' mice were subjected to two injury types: Full disc puncture (DP) mimicking advanced IVDD and annulus fibrosus and endplate (AF + EP) injury simulating herniation with endplate junction failure. Spines were tested biomechanically, analyzed radiologically for IVD dimensions, and with FTIR and histology for biochemical content.ResultsBoth age and injury significantly altered biomechanical properties of IVDs. Injury had a greater effect than age, and DP caused larger changes than AF + EP injury. Injury and age exhibited an interactive effect, resulting in more pronounced biomechanical dysfunction in middle‐aged (12 months) and geriatric IVDs (24 months), likely due to age‐related loss of proteoglycans and collagen denaturation shown with FTIR and histology.ConclusionsWe conclude that both age and injury independently and synergistically affect ex vivo biomechanical properties of mouse lumbar spine. The more severe biomechanical change in middle‐aged and geriatric mouse lumbar spines suggests similar injuries may cause greater spinal dysfunction in individuals of comparable ages. These findings provide context for future in vivo studies investigating long‐term effects of acute spine injuries.

BackgroundTraumatic spinal cord injuries often result in significant disability and impact patients’ functional independence and quality of life.ObjectiveThis study aims to evaluate neurological recovery, independence in daily activities, and overall physical performance in trauma patients with spinal injury over a 24-month follow-up, with a focus on outcomes in low-resource settings.MethodologyA prospective descriptive observational study was conducted from January 19, 2022, to December 19, 2024. A total of 216 adult patients with acute traumatic spinal injuries were enrolled. Neurological status was assessed using the American Spinal Injury Association (ASIA) Impairment Scale, including motor and sensory subscores, and functional independence was measured with the Spinal Cord Independence Measure (SCIM) at baseline, discharge, and at six, 12, 18, and 24 months post-injury. Data on acute management, complications, specific rehabilitation therapies (physical therapy, occupational therapy, ambulation training), ambulation, and occupational reintegration were collected. Statistical analysis included repeated measures analysis of variance (ANOVA) and Chi-square tests, with significance set at p < 0.05.ResultsAt baseline, 42.59% (n = 92) of patients had severe neurological impairment (ASIA A/B), which decreased to 21.30% (n = 46) at 24 months. The mean SCIM scores improved significantly from 38.60 ± 12.40 at admission to 74.90 ± 15.80 at two years (p < 0.001). Surgical intervention was performed in 68.52% (n = 148) of patients. Independent ambulation was achieved by 38.89% (n = 84), while 41.20% (n = 89) were unemployed due to disability. Common complications included pressure ulcers (11.57%, n = 25) and urinary tract infections (13.89%, n = 30) during hospitalization.ConclusionSignificant neurological and functional improvements occur over 24 months, though complications and occupational challenges persist, highlighting the need for cautious interpretation due to heterogeneity in injury levels and rehabilitation protocols, and the importance of optimized rehabilitation in low-resource settings.

Intestinal dysfunction plays a crucial role in the developing of early and late complications in patients with spinal injury. Intestinal dysfunction can lead to metabolic imbalances like maldigestion, malabsorption, and intestinal dyskinesia. The study of metabolic processes in the tissues of the intestinal tube against the spinal cord injury can help to treat enteral and colonic insufficiency and reduce the number of surgical complications. The objective of the study is to examine the dynamics of metabolic processes in the tissues of the small and large intestines in acute spinal cord injury. Materials and Methods. The experiment was performed on laboratory animals, Wistar rats (n=22). Spinal cord injury was reproduced by complete transection of the spinal cord at the level of the Th5-Th6 vertebrae. The dynamics of cellular metabolism were assessed at different time intervals during the development of post-traumatic disease in vivo using fluorescence lifetime imaging microscopy (FLIM) based on autofluorescence in the spectral channel of the metabolic cofactor NAD(P)H. Results. The acute spinal cord injury is accompanied by changes in endogenous autofluorescence of the serous membrane tissues in the small and large intestines. A decrease in the activity of metabolic processes and their catabolic orientation are noted in the small intestine. On the contrary, metabolic processes intensify over time in the large intestine Conclusion. For the first time an in vivo experiment showed that the acute spinal injury was accompanied by a disruption of metabolic processes in the intestinal tissues. Fundamental multidirectionality was observed. Thus, a more balanced approach is necessary to combat intestinal failure in patients with acute traumatic spinal cord disease.

Introduction. Spinal cord (SC) injury without radiographic abnormalities, designated as SCIWORA, occurs in children with a frequency of 6 to 19% of all spinal injuries. Anatomical and physiological characteristics of children, SC contusions and impaired blood supply to the SC are decisive in the formation of SCIWORA. Given the existing connection between the degree of SC injury and clinical outcome, MRI results are an important area of SCIWORA research. Aim: to determine role of magnetic resonance imaging in the study of SC injury with SCIWORA in children. Material and methods. The study was performed in 22 children (13 boys and 9 girls) with clinical manifestations of SCIWORA, aged from 1 year to 17 years (mean age — 7.5 ± 4.5 years). All children in the acute period initially underwent computer tomography, then MRI in 9 of them. MRI was performed within the following timeframes: from 1 hour to 72 hours in the acute period and from 4 months to 36 months in the late period. MRI was performed on a Philips Achieva dStream 3 T scanner using the standard institute protocol for SC, which included: MR myelography, T2-Dixon, 3DT2-TSE, T1-WI, SWI, diffusion tensor images. Results. According to the severity of injury using the ASIA classification, children with SCIWORA were distributed as follows: 8 — grade A (complete SC injury), 6 — grade B (incomplete sensory and motor). According to MRI data, damage to the cervical part of the SC was found in 7 patients; thoracic — in 12; the cervical and thoracic parts — in 3. In this case, hematomyelia was present in 13 cases, complete rupture — in 2 cases, contusion of SC — in 2, ischemia of SC — in 2. Small foci of hematomyelia up to 1/3 of the SC diameter or edema had a favorable prognosis and in most cases passed from 3 to 5 weeks after injury. Anatomical rupture of SC and/or large foci of hematomyelia (more than 1/2 of the SC diameter) had an unfavorable prognosis, visually manifested by atrophy, cystic-glial scars, in two observations syringomyelia, and in two cases there were additionally chronic epidural hematomas. Conclusion. High-resolution MRI with sensitivity for soft tissue contrast is of great importance for identifying the location and size of all damaged spinal structures, including the SC. The algorithm for performing MRI in acute spinal injury should include T2- and T1-WI in the SE IP, STIR in the sagittal, T2-WI in the coronal and axial projections, 3D-SWI, and diffusion images. Contrast enhancement in acute spinal injury is also an element of the algorithm in some cases.

Guillain-Barré syndrome (GBS) is a common entity in neurology clinics. A variety of etiologies have been implicated in the presentation of GBS. Although rarely reported, traumatic brain injury (TBI) has also been reported to cause GBS. In this article, we report a similar case of GBS that occurred following TBI and the patient presented with acute flaccid paraparesis with intact strength in upper limbs. Paraparesis progressed to quadriparesis simulating a case of spinal injury, without any correlating imaging findings. Nerve conduction study findings, cerebrospinal fluid studies, and clinical examination led to the diagnosis of post-TBI GBS. A review of similar cases reported in literature is also attached. High index of suspicion should be maintained for GBS in all cases of imaging-negative post-TBI limb weakness which may simulate acute spinal injury.

IntroductionIn this study, we investigate the evolution of lumbar fusion surgery with robotic assistance, specifically focusing on the impact of robotic technology on pedicle screw placement and fixation. Utilizing data from the Nationwide Inpatient Sample (NIS) covering 2016 to 2019, we conduct a comprehensive analysis of postoperative outcomes and costs for single-level lumbar fusion surgery. Traditionally, freehand techniques for pedicle screw placement posed risks, leading to the development of robotic-assisted techniques with advantages such as reduced misplacement, increased precision, smaller incisions, and decreased surgeon fatigue. However, conflicting study results regarding the efficacy of robotic assistance in comparison to conventional techniques have prompted the need for a thorough evaluation. With a dataset of 461,965 patients, our aim is to provide insights into the impact of robotic assistance on patient care and healthcare resource utilization. Our primary goal is to contribute to the ongoing discourse on the efficacy of robotic technology in lumbar fusion procedures, offering meaningful insights for optimizing patient-centered care and healthcare resource allocation.MethodsThis study employed data from the Nationwide Inpatient Sample (NIS) spanning the years 2016 to 2019 from USA, 461,965 patients underwent one-level lumbar fusion surgery, with 5770 of them having the surgery with the assistance of robotic technology. The study focused primarily on one-level lumbar fusion surgery and excluded non-elective cases and those with prior surgeries. The analysis encompassed the identification of comorbidities, surgical etiologies, and complications using specific ICD-10 codes. Throughout the study, a constant comparison was made between robotic and non-robotic lumbar fusion procedures. Various statistical methods were applied, with a p value threshold of < 0.05, to determine statistical significance.ResultsRobotic-assisted lumbar fusion surgeries demonstrated a significant increase from 2016 to 2019, comprising 1.25% of cases. Both groups exhibited similar patient demographics, with minor differences in payment methods, favoring Medicare in non-robotic surgery and more private payer usage in robotic surgery. A comparison of comorbid conditions revealed differences in the prevalence of hypertension, dyslipidemia, and sleep apnea diagnoses—In terms of hospitalization outcomes and costs, there was a slight shorter hospital stay of 3.06 days, compared to 3.13 days in non-robotic surgery, showcasing a statistically significant difference (p = 0.042). Robotic surgery has higher charges, with a mean charge of $154,673, whereas non-robotic surgery had a mean charge of $125,467 (p < 0.0001). Robotic surgery demonstrated lower rates of heart failure, acute coronary artery disease, pulmonary edema, venous thromboembolism, and traumatic spinal injury compared to non-robotic surgery, with statistically significant differences (p < 0.05). Conversely, robotic surgery demonstrated increased post-surgery anemia and blood transfusion requirements compared to non-robotic patients (p < 0.0001). Renal disease prevalence was similar before surgery, but acute kidney injury was slightly higher in the robotic group post-surgery (p = 0.038).ConclusionThis is the first big data study on this matter, our study showed that Robotic-assisted lumbar fusion surgery has fewer post-operative complications such as heart failure, acute coronary artery disease, pulmonary edema, venous thromboembolism, and traumatic spinal injury in comparison to conventional methods. Conversely, robotic surgery demonstrated increased post-surgery anemia, blood transfusion and acute kidney injury. Robotic surgery has higher charges compared to non-robotic surgery.

Spinal injuries represent a significant public health issue with both individual and societal implications due to its potential to result in long-term or permanent disability and death. Today, notwithstanding the comprehensive elucidation of the mechanism of injury in its all aspects and breakthroughs in early diagnosis techniques and treatment, spinal injuries still retain their devastating nature. Although many agents hypothesized to possess neuroprotective and neuroregenerative properties have been demonstrated to be effective in the experiments, research involving human subjects is still in progress, offering promising developments. Methylprednisolone at a high dose is the most extensively investigated therapeutic for acute spinal injuries. Despite significant controversy, it remains a viable treatment option. It is anticipated that combining stem cell transplantation with multiple pharmacological agents will yield more favorable outcomes.

Acute cervical spinal cord injury after head and neck surgery: A CARE case report

This study aimed to clarify neurological differences among the epiconus, conus medullaris, and cauda equina syndromes. Eighty-seven patients who underwent surgery for acute thoracolumbar spinal injuries were assessed. We defined the epiconus as the region from the terminal end of the spinal cord to the proximal 1.0 to 2.25 vertebral bodies, the conus medullaris as the region proximal to < 1.0 vertebral bodies, and the cauda equina as the distal part of the nerve roots originating from the spinal cord. On the basis of the distance from the terminal end of the spinal cord to the narrowest level of the spinal canal, the narrowest levels were ordered as follows: the epiconus followed by the conus medullaris and cauda equina. The narrowest levels were the epiconus in 22 patients, conus medullaris in 37 patients, and cauda equina in 25 patients. On admission, significantly more patients had a narrowed epiconus of Frankel grades A-C than a narrowed cauda equina. At the final follow-up, there were no significant differences in neurological recovery among those with epiconus, conus medullaris, or cauda equina syndrome. Anatomically classifying the narrowest lesion is useful for clarifying the differences and similarities among these three syndromes.

IntroductionSpine injury is one of the leading caused for disability in Nepal. Patients with trauma relatedspine injury leads to neurological dysfunction, focal deficits and even fatal life threating events.The timely intervention in acute spinal trauma injury could save the patients from disability andmortality risk. Imaging modalities like Xray, CT Scan and MRI helps in diagnosis and managementof spinal trauma. MRI plays crucial role in detection of spinal cord and soft tissue injuries. It issuperior than CT scan in evaluation of spinal cord injuries, ligament, soft issue structures, disc,and occult osseous injuries. The objective of this research is to evaluate MRI in acute spinal traumain tertiary center of Nepal. MethodsThis is descriptive hospital based observational study in those patients who were admitted andreferred in hospital for MRI with acute spinal trauma injury. Data were analysed by SPSS 2022. ResultsAcute spinal trauma is most common in male with ratio of 1.7 with the mean±SD of age was foundto be 50.98±19.26 years. Most common mode of injury were fall injury (76%). Most common spinalregion involved were lumbar (42%) followed by thoracic (36%), dorso-lumbar (14%) and cervical(8%) region respectively. Spinal cord contusion with edema, disc rupture, paravertebral collectionand ligament injury were seen. Most common type of fractures were simple compression fracture(72%), followed by burst fracture (16%), both (6%) and listhesis and sub/dislocations (6%). Spinalcord injury were seen in 22%, followed by disc rupture, paravertebral collection and ligamentinjury. ConclusionsMRI helps in evaluating vertebrae, spinal cord, ligament and disc injuries. We can assess the cordcontusion, edema and canal compression. It provides involvement, extension and severity of cordinjury. It endowed about outcome of surgery as well as conservative management in patient ofspinal injury.

Spinal injury rates and specific causation in motor vehicle collisions

Randomized controlled animal experiment. To determine and compare the efficacy of riluzole, MPS and the combination of two drugs in a rat model with acute spinal trauma, electrophysiologically and histopathologically. 59 rats were divided into 4 groups as control, riluzole (6mg/kg, every 12hours for 7days), MPS (30mg/kg, 2nd and 4th hours after injury) and riluzole + MPS. Spinal trauma was created and the subjects were followed for 7days. Electrophysiological recordings were made via neuromonitoring. The subjects were sacrificed and histopathological examination was made. For the amplitude values, mean alteration in the period from the spinal cord injury to the end of the 7th day is 15.89 ± 20.00%, 210.93 ± 199.44%, 24.75% ± 10.13% increase and 18.91 ± 30.01% decrease for the control, riluzole, riluzole + MPS and MPS groups, respectively. Although the riluzole treatment group produced the greatest increase in amplitude, it was observed that no treatment provided a significant improvement compared to the control group, in terms of latency and amplitude. It was observed that there was significantly less cavitation area in the riluzole treatment group compared to the control group (P = .020). (P < .05). Electrophysiologically, no treatment was found to provide significant improvement. Histopathologically, it was observed that riluzole provided significant neural tissue protection.

To explore effect of short-segment pedicle screw internal fixation combined with hyperbaric oxygen in treating acute spinal fractures and its influence on recovery of spinal nerve function. A total of 96 patients with acute spinal fracture admitted from February 2017 to March 2020 were divided into combined group and control group, with 48 cases in each group. Both groups were treated with short-segment pedicle screw internal fixation. The combined group was given hyperbaric oxygen after surgery. The operation time, surgical blood loss, incision length and other general operation conditions between two groups were recorded. The differences in spinal morphology and function, Ameraican Spinal Injury Assiciation(ASIA) neurological function grade, serum inflammatory factors and ability of daily living activities were observed before and after surgery. There was no significant difference in operation time, surgical blood loss, and incision length between combined group and control group(P>0.05). There were no significant differences in anterior height ratio and Cobb angle between two groups before surgery, 1 week and 6 months after surgery(P>0.05). The height ratio of anterior margin of the injured spine was significantly improved in both groups at 1 week and 6 months after surgery compared with preoperative period (P<0.05), and Cobb angle was significantly reduced in both groups compared with preoperative period (P<0.05). There was no statistically significant difference in serum interleukin-6(IL-6), interleukin-8(IL-8), and tumor necrosis factor-α(TNF-α) levels between two groups at 1 d after surgery(P>0.05);the serum IL-6, IL-8, and TNF-α levels of combined group were lower than those of control group at 1 week after surgery (P<0.05). At 6 months after surgery, ASIA neurological function grade of combined group was C grade in 2 cases, D grade in 23 cases, E grade in 22 cases. In control group, 7 cases was grade C, 26 cases was grade D, 13 cases was grade E, and the difference between two groups was statistically significant(P<0.05). The Barthel score of combined group was higher than that of control group at 1 month and 3 months after surgery, and the difference was statistically significant (P<0.05);at 6 months after surgery, there was no significant difference in Barthel score between two groups(P>0.05). Short-segment pedicle screw internal fixation combined with hyperbaric oxygen for the treatment of acute spinal fractures is beneficial to the recovery of spinal nerve function after surgery, and has a certain effect on the early improvement of the patients' activities of daily living.

Introduction. Spinal cord injury is a debilitating traumatic event in central nervous system resulting in tissue destruction and severe neurological deficit development. Preclinical assessment of quantitative lesion area parameters (e. g. structure and volume) is critical for subsequent evaluation of neuroprotective and / or neuroregenerative therapy efficiency. Current methods for parameter calculation require manual limitation of the interested area (region of interest, RoI). This process is tedious and often not precise enough.Study objective is to develop and implement software for automated assessment of volume and structure of posttraumatic spinal cord lesion using extra-high-field MRI 7.0 Tesla and to compare methods preciseness with the current manual techniques.Study design. Ten rat models of acute severe spinal cord contusion injury were used including female Sprague–Dawley animals weighting 250–350 gr. MRI imaging was performed in 1 day postoperative and then 4 times with interval (1 week). Study was prospective open-label uncontrolled comparative.Materials and methods. Standard spinal cord contusion injury model was used. Anesthetized animals underwent laminectomy at level Th9–Th10 vertebrae followed by “weight drop” injury technique application: 10 g weight with 2 mm pin diameter dropped from 25 mm height. Software was developed using Microsoft Visual Studio 2017 environment and programming language C#. Statistical analysis was performed using IBM SPSS Statistics 21.0 software.Results. We developed and patented specialized software Spinal cavity Searcher realizing the algorithm of T2‑weighted images (T2‑WI) analysis based on image bynarization and Freeman chain code. This algorithm supports calculation of spinal cord posttraumatic lesion parameters in a half-automatic manner. Results of this algorithm application were comparable to results of manual calculation: no statistical difference were observed between two values.Conclusion. Current method of spinal cord injury volume and structure quantitative assessment simplifies the calculation procedure due to automatization of RoI limitation comparing to manual technique. The level of preciseness is comparable in both methods.Clinical relevance. The developed algorithm optimizes the process of non-invasive control of the performed treatment efficiency according to 7.0 Tesla MRI data.

Objectives To elucidate the incidence and risk factors for pneumonia after acute traumatic cervical spinal cord injury (CSCI) Design Retrospective cohort study. Setting: Spinal injuries center in Japan. Participants: Of 184 individuals who were admitted within 2 weeks after acute traumatic cervical spinal injuries, 167 individuals who met the criteria were included in this study. Interventions: The occurrence of pneumonia, degree of dysphagia using the Dysphagia Severity Scale, patient age, history of smoking, presence of tracheostomy, vital capacity, level of injury, and the American Spinal Injury Association Impairment Scale (AIS) 2 weeks after injury were assessed. Outcomes: Incidence of pneumonia were analyzed. Moreover, the risk factors of pneumonia were evaluated using logistic regression analysis. Results From the 167 individuals who met the criteria, 30 individuals (18%) had pneumonia; in 26 (87%) of these individuals, pneumonia was aspiration related, defined as Dysphagia Severity Scale ≤ 4. The median occurrence of aspiration pneumonia was 11.5 days after injury. A logistic regression analysis revealed that severe AIS and severe Dysphagia Severity Scale scores were significant risk factors of pneumonia after CSCI. Conclusions It was highly likely that the pneumonias following CSCI were related to aspiration based on the Dysphagia Severity Scale. In addition, most of the patients developed aspiration pneumonia within 1 month after injury. Aspiration and severe paralysis were significant risk factors for pneumonia. The treatment of dysphagia in the acute phase should be considered an important indicator to prevent pneumonia.