Figure 4: Patient presented with history of fall from height 1 day prior to date of MRI. Sagittal T2W MR imaging shown fracture dislocation at D4-5 level with grade 4 spondylolisthesis of D4 over D5 with fracture of D5, contusion of cord in about 3.4 cm span , a small focus of hemorrhage in cord (8 mm), a small epidural hematoma and severe cord compression. On clinical exam AIS at admission was A. Patient was followed till discharge, no improvement was noted. Presence of long length of cord involved severe cord compression and were responsible for high-grade AIS at admission and discharge.