Background: Acute traumatic spinal cord injury (ATSCI) frequently has catastrophic effects on patients' motor, sensory, and autonomic functions and general physical and mental health. This study aimed to assess changes in magnesium levels in patients with acute traumatic spinal cord injury and explore its potential association with neurological remission.

Methodology: This was a prospective observational study conducted on 26 patients of ATSCI admitted to the hospital within 24 hours of the incident. At the time of admission, participants' demographic and clinical information was gathered, including their age, gender, mechanism of damage, duration since injury, degree and severity of spinal cord injury, and any accompanying neurological abnormalities. Serum magnesium was assessed at the time of admission, after 12 hours, on the third, fifth and seventh days, and in the sixth and twelfth weeks. Data was analysed using MS Excel and SPSS version 16.0.

Results: The patients' mean (±SD) age was 33.24 (±12.51) years. Most patients in this study experienced falls from a height, with 88% being males. There were almost equal proportion of cases with thoracic and lumbar lesions. At admission, 72% of patients had complete spinal cord injury, and the remaining 28% had incomplete spinal cord injury. Magnesium levels demonstrated significant fluctuations across the time points, with a decrease observed within 12 hours of admission. The stratified analysis revealed a significant decline in serum Mg for the first week only among cases without neurological remission. At the same time, those that improved neurologically did not significantly decline serum Mg concentrations for the corresponding time points.

Conclusion: This study demonstrated the dynamic changes in serum magnesium post-traumatic spinal cord injury and observed that low and declining serum magnesium levels in the first week were significantly associated with neurological remission. Future research should consider larger sample sizes, more extended follow-up periods, and a comprehensive assessment of confounding variables to enhance our understanding of magnesium's neuroprotective effects and its therapeutic implications for spinal cord injury. Keywords: Acute Traumatic Spinal Cord Injury, Serum Magnesium level, Neurological recovery.