All patients will undergo active rehabilitation.

All Patients are  followed up at monthly interval . Neurological evaluation will be done at 3 monthly interval by a neurologist and will be graded according  to ASIA protocol.

Electrophysiological evaluation for recovery of MEP or SEP and MRI for changes in anatomy of cord   will be done at 6 months then after at one year.

After clinical (ASIA) and MRI staging of severity (contusion  & total disruption  with or without gap) we start with -

Postural reduction

Hypothermia –

Maintain Blood Pressure on higher side

Maintenance of arterial oxygen levels

Followed by Decompressive surgery with fixation +\- omental transposition as early as possible.

Omentum transposition in acute setting is  indicated only in pure contusion in injuries

Omentum transposition should be deferred for at least 2-6 weeks in  patients with laceration /maceration

There are high chances of  loosing  living  swollen grey matter .

Patients should be serially evaluated and monitored for progression of odema resolution.

(these observations are derived from a the first ever clinical trial omental transposition with dr Harry Goldsmith (pioneer in omental transposition surgery  in acute sci in supported ISCI Iceland)