Abstract
This study aimed to compare the effects of early versus delayed electroacupuncture (EA) intervention on neurological recovery in patients with traumatic spinal cord injury (TSCI), in order to clarify the optimal timing of EA and provide clinical evidence for targeted rehabilitation strategies. A retrospective cohort study was conducted including TSCI patients treated between March 2020 and April 2025. Based on the initiation time of EA, patients were divided into an early intervention group (EA within 2 weeks postinjury) and a delayed intervention group (EA > 2 weeks and ≤ 2 months postinjury). Baseline demographic and clinical characteristics, treatment parameters, and pre- and posttreatment outcomes were collected. Neurological function was evaluated using the American Spinal Injury Association (ASIA) motor and sensory scores and ASIA impairment scale (AIS) grade. Functional recovery was assessed by the functional independence measure (FIM) and modified Barthel Index (MBI), and pain was measured using the visual analogue scale (VAS). Statistical analyses were performed with SPSS 26.0, and P < .05 was considered significant. Ninety-two patients met the inclusion criteria (46 per group). Baseline characteristics were comparable between groups (P > .05). At 6 months, the early group showed a higher rate of AIS grade improvement (60.9% vs 37.0%, χ² = 5.126, P = .024) and a greater proportion achieving functional ambulation (AIS D-E: 65.2% vs 47.8%, χ² = 4.017, P = .045). Improvements in ASIA motor (19.3 ± 6.4 vs 14.2 ± 5.9, P = .001) and sensory scores (both P < .01) were significantly greater in the early group. Functional outcomes also favored early intervention, with higher gains in FIM (36.3 ± 8.1 vs 30.3 ± 7.9, P = .001) and MBI (37.2 ± 7.5 vs 32.2 ± 7.3, P = .001). Pain relief was more pronounced (VAS reduction: 3.6 ± 1.0 vs 2.7 ± 1.1, P < .001), and the overall complication rate was lower (21.7% vs 43.5%, P = .022). Early EA intervention significantly improves neurological and functional recovery, enhances pain relief, and reduces complications in TSCI patients. Compared with delayed treatment, early EA demonstrates superior efficacy and safety, supporting its early application in rehabilitation protocols.