Introduction: Nogo-A, also known as reticulon 4, belongs to the reticulon family of proteins, where it is primarily expressed in oligodendrocytes, where it is localised to the membranes of myelin sheaths. The expression pattern of Nogo A after injury will enable the development of methods to effectively manipulate its levels, which will be beneficial for treating axonal regeneration after spinal cord injury.

Methods: This prospective case-control study included 27 patients with ASCI and 27 age and sex- matched healthy controls. Serum Nogo-A levels were measured using ELISA at baseline and at 3 months. Neurological recovery was evaluated using the ASIA Impairment Scale (ASIA) and the Spinal Cord Independence Measurement (SCIM).

Results: Serum Nogo A levels in ASCI patients were significantly higher than those of controls at baseline (4.1309 ±0.400 ng/ml vs. 2.0266 ±0.194 ng/ml; p

< 0.05) and at 3 months (p < 0.05). Additionally, when comparing Serum Nogo A levels among cases, they were higher in the paraplegia group than in the paraparesis group. Elevated serum Nogo A levels correlated with greater injury severity and poorer neurological outcomes.

Conclusion: Elevated serum Nogo A levels often indicate poor prognosis in SCI patients, and it is used as a prognostic biomarker to predict the prognosis of SCI.