Spinal Cord Injury (SCI) leads to severe neurological impairment due to irreversible damage to spinal axons and limited Spinal Cord Injury (SCI) causes severe neurological impairment due to irreversible axonal damage and limited regenerative capacity. Current treatments, including surgical decompression and neuroprotective agents, have limited effectiveness, with no consensus on the optimal therapeutic combination. Anti-Nogo-A therapies show promise in preclinical studies, but their clinical efficacy remains uncertain. Emerging evidence suggests that serum Nogo-A levels may serve as prognostic biomarkers for neurological recovery in SCI patients. This study explores the potential of targeting the Nogo A/Nogo receptor pathway to enhance axonal regeneration and support the development of personalized treatment strategies.