Comprehensive management and care of spinal-cord-lesioned patients start at the site of injury or at the moment of the onset of paralysis, depend with its consequences on the treatment in the acute phase, pass to the reactivation and rehabilitation phase and continue throughout all life of such patients. Considering that even a complete transverse lesion is only an instable, temporarily balanced situation, every small complication can destroy this balance and may lead from total independence to total dependence. Orthopedic, neurological, neurosurgical, urological, physio- or ergotherapeutic, socio-professional or other aspects in the field of comprehensive care and rehabilitation can never be analyzed or managed singularly, but have to be seen always in the context of the whole final outcome. The coordinating role of the paraplegiologist and the importance of adequate spinal cord injury units is stressed. The changing pattern of aetiopathogenesis or epidemiology of spinal cord lesions (increase of medical causes such as vascular lesions, tumors, infection disease) and the definition for rehabilitability due to the higher amount of elderly people will bring a new challenge for all careers in the field of rehabilitation.