For a monocentre case-control study, after a traumatic cervical spinal cord injury (SCI), researchers wanted to determine the effects of spinal surgical adverse events (SSAE) on the clinical and functional result, duration of stay, and treatment costs. Because of the emergency environment and varied injury patterns, traumatic SCI is difficult for primary care facilities. SSAE rates of up to 15% for spine fractures without SCI have been documented. Little is known about SSAE and its impact on outcomes following traumatic SCI. From 2011 to 2017, individuals with acute traumatic cervical SCI were enrolled. In terms of neurological recovery, functional result, secondary complications, mortality, duration of stay, and treatment expenses, cases with and without SSAE were compared. The ASIA impairment scale (AIS)-conversion and dysphagia, adjusted logistic regression, and generalized estimating equation models were used for the endpoints. All analyses were performed on the entire sample as well as a propensity score-matched sample. In 37 of the 165 cases, at least one SSAE was found (22.4%). The most common SSAEs were mechanical instability and insufficient spinal decompression, with 13 (7.9%) and 11 (6.7%) cases. In the matched group, regression models adjusted for demographic, injury, and surgery variables revealed a lower risk of AIS-conversion associated with SSAE (OR [95% CI] 0.14 [0.03–0.74]) and single-sided ventral or dorsal surgical approach (0.12 [0.02–0.69]). Furthermore, in both the matched (4.77 [1.31–17.38]) and total samples (5.96 [2.07–17.18]), SSAE was linked to a higher risk of dysphagia. In instances with SSAE, primary care costs were greater (median [interquartile range] 97,300 [78,200–112,300] EUR) than in those without SSAE (52,300 [26,700–91,200] EUR). SSAE is a significant risk factor for neurological recovery, functional outcome, and healthcare expenses following an acute traumatic cervical SCI. SSAE reduction is a promising way to protect the limited inherent capacity for SCI recovery.