ATLS guidelines are considered standard for clearing the C-spine all over the world in any trauma patient. As per the guidelines, in patients with dangerous mechanism of injury, CT C-spine is considered as gold standard to clear C-spine in patients with absent initial permanent or transient neurological abnormalities. We are presenting a case of a 62 years old male who suffered from a RTA with dangerous mechanism of injury. Despite clearance of C-spine as per ATLS protocol , patient eventually landed up in quadriplegia; thus raising the question in mind that whether ATLS protocol is enough or we need to think beyond it for decreasing morbidity in such cases.

Keywords: Cervical Spine; Spinal Cord Injury; Acs in Trauma; Quadriplegia; Spine Immobilisation.