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To determine the pattern of traumatic spinal injuries and their management in patients admitted to a Neurosurgical Unit of a tertiary care hospital in southeast Iran.All patients admitted with spinal injuries between 1st October 2004 and 30th October 2009 from the Department of Neurosurgery, Kamyab Hospital, Mashad, were included. Information was recorded and analyzed with respect to demographic data, mechanism of injury, level of bony injury, and outcome.A total of 377 patients were admitted, comprising 261 male patients (69.2%) and 116 female patients (30.8%). The most affected patients were between 26 and 35 years of age (22.5%), followed by patients who were between 16 and 25 years (22.3%). The most common causes of injuries were road accidents in 211 patients (56%), followed by fall in 111 patients (29.4%). Thoracolumbar spine was affected in 198 (52.5%) cases, followed by lumbar spine in 85 (22.5%) cases and thoracic spine in 23 (6.1%) cases. A total of 233 patients (61.8%) had no associated injury, and the most common associated injury was limb trauma (86/377, 22.8%). A total of 308 patients (81.7%) were neurologically intact and 31 (8.2%) of them were complete paraplegic and the rest of the patients (10.1%) had incomplete neurological deficit.This study shows that young adults, especially men in their most productive years of life, are prone to spinal cord injury. Road accident is the most common preventable cause of spinal injury. Recognizing the pattern of spinal injury helps us to identify high-risk groups, which will then help us to design more appropriate preventive measure.