The incidence of spinal cord injury without fracture dislocation is increasing and can be divided into four types: (1) Children’s cervical SCIWORA: seen in children from 6 months to 16 years old, more than half of them under 8 years old, mostly due to serious injuries such as car accidents, high falls, pulling, etc. Due to the greater elasticity of the spine, spinal cord injury can occur without fracture dislocation, about half of the central spinal cord injury, followed by complete spinal cord injury, incomplete spinal cord injury, individual Brown Sequard. One of its characteristics is that about half of the cases have a latency period from a few hours to 4 d after the injury to the appearance of spinal cord injury. (2) SCIWOFD in middle-aged and elderly people: it is more common in people over 50 years old. Minor injuries such as falls, bruises and other posterior extension injuries account for the majority of cases, but can also occur in traffic accidents or falls from height, paraplegia occurs immediately after the injury, central spinal cord injury accounts for about 70%, the other complete spinal cord injury, incomplete spinal cord injury, Brown Sequard and nerve root injury. x-ray, CT, MRI and other imaging examinations, found that spinal stenosis accounted for 70%, anterior longitudinal ligament injury, disc Herniated more than half, posterior longitudinal ligament bleeding, rupture of supraspinous ligament, etc. Individuals with vertebral fractures but no displacement, so they failed to show on X-ray. Spinal cord changes such as compression, softening and rupture are consistent with the clinical presentation. (3) SCIWORA of the thoracic spine: mainly occurs in children and young adults, the age of the children’s group is from 1 to 11 years old, and the young adults are from 18 to 38 years old. The cause of injury is a car accident, rolling injury, rolling injury and other serious crushing injury, adults immediately after injury paraplegia, children have half of the incubation period, since the injury 2h ~ 4d before paraplegia, paraplegia plane in the upper thoracic spine accounted for 1/3, in the lower thoracic spine accounted for 2/3, the majority of complete paraplegia, and delayed flaccid paralysis, which is due to large segment of the spinal cord necrosis. Thoracic SCIWORA also has a characteristic that more thoracic or abdominal associated injuries, which can reach more than half, the thoracic injuries are mainly multiple rib fractures and hemothorax, while the abdominal injuries are mainly ruptured liver and spleen bleeding. Thoracic SCIWORA injury mechanism may have A large medullary artery (GMA) injury, B due to the thoracic and abdominal cavity pressure increase caused by intravertebral hypertension, small arteriovenous hemorrhage and spinal cord ischemic injury, some cases showed bleeding in the cerebrospinal fluid (csf). (4) Transient lumbar SCIWOFD, rare.