Evaluating Long-Term Neurological and Functional Recovery in Acute Traumatic Spinal Cord Injury: A Prospective Cohort Study

Background Traumatic spinal cord injuries often result in significant disability and impact patients' functional independence and quality of life. Objective This study aims to evaluate neurological recovery, independence in daily activities, and overall physical performance in trauma patients with spinal injury over a 24-month follow-up, with a focus on outcomes in low-resource settings. Methodology A prospective descriptive observational study was conducted from January 19, 2022, to December 19, 2024. A total of 216 adult patients with acute traumatic spinal injuries were enrolled. Neurological status was assessed using the American Spinal Injury Association (ASIA) Impairment Scale, including motor and sensory subscores, and functional independence was measured with the Spinal Cord Independence Measure (SCIM) at baseline, discharge, and at six, 12, 18, and 24 months post-injury. Data on acute management, complications, specific rehabilitation therapies (physical therapy, occupational therapy, ambulation training), ambulation, and occupational reintegration were collected. Statistical analysis included repeated measures analysis of variance (ANOVA) and Chi-square tests, with significance set at p < 0.05. Results At baseline, 42.59% (n = 92) of patients had severe neurological impairment (ASIA A/B), which decreased to 21.30% (n = 46) at 24 months. The mean SCIM scores improved significantly from 38.60 ± 12.40 at admission to 74.90 ± 15.80 at two years (p < 0.001). Surgical intervention was performed in 68.52% (n = 148) of patients. Independent ambulation was achieved by 38.89% (n = 84), while 41.20% (n = 89) were unemployed due to disability. Common complications included pressure ulcers (11.57%, n = 25) and urinary tract infections (13.89%, n = 30) during hospitalization. Conclusion Significant neurological and functional improvements occur over 24 months, though complications and occupational challenges persist, highlighting the need for cautious interpretation due to heterogeneity in injury levels and rehabilitation protocols, and the importance of optimized rehabilitation in low-resource settings.