A spinal cord injury can be devastating to the victim. The management of spinal cord injury secondary to gunshot wounds or other ballistic injuries is still controversial. In the United States of America, a gunshot wound is the second most common cause of spinal cord injury. In one civilian series, up to 25% of all spinal cord injuries were secondary to gunshot wounds. This is a condition affecting mainly young people under 30 years of age, more than 90% of whom are males. Over a third will be under the influence of alcohol or drugs, and nearly half will be shot from behind. Over half of such injuries will present with complete paraplegia. By the nature of the inflicting injury, more than one quarter will have associated injuries. The majority of the gunshot wounds affect the thoracic spine, with the lumbar spine being second most common.