COPR Advanced Care Paramedic (ACP) Practice Exam

Secondary spinal cord injury is the cascade of vascular, cellular, and inflammatory processes that follow the initial trauma, with swelling driving much of the progression. After the primary injury, edema within and around the cord increases intraspinal pressure, reduces capillary perfusion, and worsens ischemia, leading to more neuronal death. This progressive swelling best captures the mechanism, whereas direct mechanical damage is the initial insult, and infection or degenerative disease are not the acute drivers of this secondary cascade.