Fortunately serious spinal injuries from recreational activities are fairly rare. Spinal fractures are most commonly seen in road accidents and falls from height such as downstairs or off ladders. 

Less commonly we do need to manage spinal fractures sustained in possibly lower energy accidents such as trampoline somersaults, falls off pushbikes or mountain bikes, and contact sport. Diving into shallow water is also a high risk activity for a spinal fracture.

Powered recreational vehicles do present an added danger, particularly as there may be no formal training in their use. Examples include quad bikes, hover boards and more recently electric bikes.

Most spinal fractures can be managed conservatively with bracing for 12 weeks. Spinal surgery may be recommended if there is damage to the nerves or spinal cord, or if internal fixation (screws and rods) are needed to prevent later spinal deformity and delayed neurological injury.

The recommendation of spinal surgery does not necessarily imply a spinal cord injury and the vast majority of spinal fracture patients will make a full recovery with expert management. 

Unfortunately there are rare patients who suffer serious spinal cord injury at the time of impact and who will need lifelong expert care.

The stories in the media so far suggest that Simon Cowell has suffered a serious injury to his spinal column requiring surgery, but not a spinal cord injury. If that is what has occurred, then he should expect a full recovery.