<h3>BACKGROUND CONTEXT</h3> The AO Spine Subaxial and Thoracolumbar Injury Classifications denote "Type C" fractures as dislocation-translation type injuries. These injuries are often grossly unstable due severe ligamentous compromise, which place patients at high risk for spinal cord injury (SCI). While prior research has investigated the role of early surgical decompression on neurologic outcomes, the relationship between the amount of vertebral column displacement and preoperative neurologic injury and postoperative neurologic recovery has been poorly documented. <h3>PURPOSE</h3> The purpose of this study is to 1) identify if preoperative vertebral column displacement (in millimeters) is predictive of a complete SCI (defined as ASIA A) prior to fracture fixation and 2) identify if the preoperative or postoperative vertebral column displacement is predictive of no postoperative neurologic improvement (ie, no improvement in ASIA score) following fixation. <h3>STUDY DESIGN/SETTING</h3> Retrospective cohort study. <h3>PATIENT SAMPLE</h3> All patients with cervical or thoracolumbar Type C injuries between 2006-2021 were identified from a prospectively collected database. Only patients who underwent operative intervention were included. <h3>OUTCOME MEASURES</h3> Neurologic injury and/or recovery based on the ASIA Impairment Scale. <h3>METHODS</h3> Patient demographics, surgical characteristics and clinical outcomes were collected. Preoperative and postoperative CT scans or MRI were utilized to measure the fracture-dislocation translation (in millimeters [mm]) prior to and following surgical fixation. Receiver operating characteristic (ROC) curves were generated to predict the probability of a SCI prior to reduction and fixation based on the preoperative fracture-dislocation displacement with optimal cutoffs identified using Youden's index. A second ROC curve was generated to predict the probability of having no postoperative neurologic recovery following reduction and fixation. Alpha was set at P<0.05. <h3>RESULTS</h3> A total of 67 patients were included. The cohort was predominantly male (80.6%) with a mean age of 42.9 + 18.8 years. The majority of the injuries involved cervical vertebrae (n=45; 67.2%). The mean preoperative vertebral column displacement was 10 + 10 mm, and the mean postoperative vertebral column displacement was 1.87 + 2.08 mm. A majority of patients (n=61, 91.0%) underwent neurologic decompression within 24 hours following admission. Of the 67 patients, 42 (62.7%) were determined to have a complete SCI (ASIA A) upon admission; two patients experienced neurologic deterioration following surgery and 7 patients experienced some degree of neurologic recovery. ROC analysis identified 6.10 mm (AUC: 0.771, CI: 0.650-0.892) of preoperative vertebral column displacement as an optimal cutoff, predictive of a complete SCI. ROC analysis also identified 6.70 mm (AUC: 0.654, CI: 0.421-0.887) of preoperative vertebral column displacement and 5.40 mm (AUC: 0.427, CI: 0.214-0.639) of postoperative vertebral column displacement as optimal cutoff values predictive of no postoperative neurologic recovery following fixation. <h3>CONCLUSIONS</h3> The distance of vertebral column translation in subaxial cervical and thoracolumbar AO Spine Type C injuries is highly predictive of a complete SCI. However, the amount of preoperative fracture-dislocation translation is only mildly predictive of neurologic recovery. The remaining postoperative fracture-dislocation displacement had no predictive effect on neurologic recovery. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.