Acute spine and spinal cord injury is one of the serious types of injuries with a high disability rate in trauma patients, typically caused by high-energy injury mechanisms such as falls from height, traffic collisions, and violent impacts. It is characterized by rapid onset, severe illness, and complex treatment. Due to the involvement of multifaceted pathological alterations such as spinal fracture-dislocation, spinal cord compression, and neurological dysfunction, the entire treatment process includes important milestones such as early assessment and grading, rapid transport and imaging diagnosis, timely decompression and fixation, prevention and control of complications, and rehabilitation management. This consensus is developed based on the latest international and domestic guidelines and literature evidence, combined with clinical practice in China, through multidisciplinary collaboration among experts in orthopedics, neurosurgery, critical care medicine, emergency medicine, and rehabilitation medicine. It aims to standardize the early identification and grading, imaging evaluation and surgical treatment, perioperative management, and rehabilitation intervention for adult acute spine and spinal cord injury in China, so as to improve the overall rescue level and functional prognosis. This consensus has been registered on the Practice guidelines REgistration for transPAREncy (PREPARE) platform, with the registration number PREPARE-2025CN1399.