A 23-year-old female sustained a fall while pole dancing in an inverted position 1 m off the floor. This resulted in a direct axial impact on the vertex of the head that precipitated the onset of an acute quadriparesis (Motor Index Score [MIS] of 64/100, with a C5 motor and T2 sensory level). The injury was originally classified as an American Spinal Injury Association Impairment Score D,[] but later reclassified to a C due to motor deterioration (MIS 41/100). Acute spinal cord injury (SCI) management was initiated, including NASCIS 2 methylprednisolone protocol.[] Brain and spine CT/MR studies documented a C4-C5 flexion/distraction injury, an acute anterior disc extrusion with superior migration, complete bilateral jumpted facet joints, and complete disruption of the posterior ligamentous complex []. The MR also demonstrated a T2 hyperintense signal within the cord at the C4-C5 level, consistent with a SCI (AOSpine classification C4-C5 fracture: C, F4 unilateral, N3, M2.) []. Preoperatively, cervical traction was applied under anesthesia/fluoroscopic control confirming marked instability; 8.8 pounds of traction resulted in reduction of the C4-C5 listhesis/dislocation, but had to be reduced to 6 pounds with mild neck extension to preserve the achieved reduction. A C4-C5 anterior discectomy was performed utilizing a PEEK cage and plate fusion; the surgery was completed within 7 hours after the accident. A secondary posterior C4-C5 lateral mass screw/ rod fusion was performed to address the posteriorly disrupted ligamentous complex []. The patient presented progressive neurological recovery. Six months postoperatively, the MR showed residual C4-C5 myelomalacia but adequate cord decompression, while clinically she had regained full motor function with only mild residual dysesthesias in the fingers. Six-years later, she was clinically normal [].