A) This 36-year-old male presented with a complete C5-level tetraplegia and high-grade open fractures of three of his extremities following a high-speed rollover accident. Lateral cervical trauma radiographs demonstrated interspinous C5–6 widening and loss of facet parallelism. The patient received intravenous methylprednisolone and aggressive volume resuscitation. B) An emergency MRI scan demonstrates a large traumatic disc herniation at the C5–6 interspace and disruption of the posterior ligamentous structures of the same level. C) Concomitant with surgical care of the open extremity fractures, an emergency anterior C5–6 discectomy with bone graft and instrumentation was carried out. The time from injury to surgical decompression was calculated to be 6h. The patient improved to an ASIA D level of function within 5 months of injury and currently is a household ambulator living independently.