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BACKGROUND Aim of our study is to analyze the impact of Early Tracheostomy (ET) in patients with cervical-spine (C-spine) injuries. METHODS We analyzed seven-year (2010-2016) ACS-TQIP databank and included all non-TBI trauma patients diagnosed with c-spine injuries. Patients were stratified into two groups based on the timing of tracheostomy (Early; ≤7days Late; 7days). Outcomes were complications, hospital and ICU stay. Regression analysis was performed. RESULTS We included 1139 patients. Mean age was 47 ± 12, median ISS was 18 [12