The Spinal Cord Injury Committee of the Neurotrauma Section is developing Guidelines for the Management of Spinal Cord Injury, and assessment of the role of decompression in spinal cord injury (STASCIS study). The Guidelines group met at the 1997 AANS Annual Meeting and formulated a series of questions which will be examined relative to the management of acute spinal cord injury. These include pre-hospital care and transport of patients suspected of having a spine injury; pharmacological management; optimal critical care; and the role of traction, decompression and surgical stabilization. A prospective, non-randomized feasibility study (STASCIS) has been underway over the last six months to examine whether it is possible to decompress patients with acute spinal cord injury within 8 hours after trauma. The results indicate that the 8-hour time window is not feasible, but that a 12-hour time window should be. A multicenter study is currently in progress to develop reproducible, quantitative, and clinically relevant radiographic outcome measures to assess cord compression. These instruments will be used in the planned prospective, controlled study of the timing of surgical decompression in spinal cord injury.