When should I refer a patient with a spinal cord injury to a specialis

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Refer a patient with a spinal cord injury to a specialist for further evaluation and management:

Within 24 hours of diagnosis, using the national spinal injuries database .
For ongoing advice and support throughout inpatient stay and at discharge, involving the regional specialist spinal cord injury centre outreach team .
When initial assessment indicates neurological abnormality attributable to spinal cord injury, perform MRI after CT, regardless of CT findings .
If imaging shows a new spinal column fracture, image the rest of the spinal column .
In cases of suspected thoracic or lumbosacral spine injury with abnormal neurological signs or symptoms, perform CT imaging .

When should I refer a patient with a spinal cord injury to a specialist for further evaluation and management?