Prevention of spinal cord injuries requires a continuum of strategies comprising primary, secondary, and tertiary measures, with the former beginning prior to the injury and the latter continuing for the lifetime of the injured person. Primary prevention is based on detailed epidemiological studies and is facilitated by ongoing registries. Primary prevention involves education, legislation and enforcement, and engineering and technological measures. Secondary injury prevention is the responsibility of the entire health care system and includes first aid, retrieval, and acute hospitalization of the injured person, whereas primary and tertiary injury prevention are the concerns of everyone in the community, both medical and nonmedical personnel. ThinkFirst is a targeted spinal cord injury prevention program that is active in many countries.

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