It doesn’t, not always. It’s possible to recover completely and be fine; it’s also possible to become a quadriplegic. It’s also possible that, yes, you die.
It all has to do with the *spinal cord,* the bundle of nerves inside your spine. If *that* breaks, your brain becomes separated from your body and can no longer direct it. If it breaks high enough, you can no longer breathe, and you’ll probably die in that case.
But it’s by no means an assured thing like the movies would have us believe.
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