Four main characteristic mechanisms of primary injury have been identified that include: (1) Impact plus persistent compression; alone with transient compression; (3) Distraction; (4) Laceration/transection. The most common form of primary injury is impact plus persistent compression, which typically occurs through burst fractures with bone fragments compressing the spinal cord or through fracture-dislocation injuries. Impact alone with transient compression is observed less frequently but most commonly in hyperextension injuries . Distraction injuries occur when two adjacent vertebrae are pulled apart causing the spinal column to stretch and tear in the axial plane. Lastly, laceration and transection injuries can occur through missile injuries, severe dislocations, or sharp bone fragment dislocations and can vary greatly from minor injuries to complete transection