With a cure of SCI still far from being available, a strong emphasis should rightfully be placed on injury prevention efforts, especially since so many of these injuries affect young patients injured under commonly avoidable circumstances. As demonstrated in several case examples, frequently legislative actions have demonstrably shown reduction of injury rates. The controversies of choosing a specific type of surgical intervention in patients with complex cervical spine fractures are addressed in the second lecture of this program. From the Series:Seventh Annual Harborview Spine Symposium: Improving Outcomes of Spinal Injury