The commonest mechanisms of injury in the cervical region are automobile accidents, in which there is rapid deceleration with forced flexion of the head; falls on the head, such as diving into too shallow water; whiplash injuries, and direct blows. In the lumbar region the commonest mechanisms are falls from a height on the feet or in the sitting position, or the sudden losing of one's footing with a lurch forward. Violent muscular contractions, such as in extremely heavy lifting or in Metrazol or electric shock, can produce fractures of the spinal column. Many injuries which did not originally have neurologic involvement, because of injudicious handling become so complicated. Handling of patients with suspected spinal column damage must be undertaken with extreme care. The patient should be very cautiously rolled onto a stretcher, extreme care being used to avoid any flexion, or, to a less degree, extension, of the spine.