Traumatic spinal cord injuries (TSCI) are life-changing events from medical, physical, psychological, social, financial, vocational, environmental & matrimonial effects. The combination of consequent generalized physiological impairment, multi-system malfunction, multiple disabilities, wide range of potential complications, sensory impairment together with the non-medical effects impose challenges to patients, carers and clinicians.1 Early prediction of ambulation is important to the patient especially during the early stages following injury. Neurological Recovery is not uncommon following spinal cord damage and is predictable. Neurological recovery does not entirely depend on the method of management of the spinal injury. The prognostic indicators of neurological recovery, its extent and the factors that enhance, prevent or cause neurological deterioration will be discussed. I be demonstrate that the management of the multi-system physiological impairment and malfunction is as important as the management of the injured spine is an optimum recovery is to be expected.