Spinal cord injuries (SCI) affect the anatomy and physiology of the spinal cord and result in characteristic changes. Identifying the impairments resulting from SCI is vital for the health care provider. Specifically, this article focuses on neurologic decline after SCI in the subacute to chronic stages. This includes changes in spasticity and its management over time, management of neuropathic pain after SCI, the development of spine complications (posttraumatic syrinx, spinal cord tethering, and so forth), management of dual-diagnosis traumatic brain injury and SCI, and other neurologic complications in chronic SCI management, such as upper-extremity entrapment mononeuropathies.