Advancements in Spinal Cord Injury Treatment: Integrating Drug Delivery, Biophysical Stimulation, Cell-Based Therapies, and Tissue Engineering Approaches

Spinal cord injuries, whether resulting from traumatic or nontraumatic events, have severe and lasting detrimental effects on individuals, significantly impacting their overall health, mobility, and quality of life. The limited regenerative capacity of the spinal cord is mainly due to neuronal damage, the presence of inhibitory molecules, an impaired immune response, and the formation of glial scars, all of which create a hostile environment for neural repair and functional recovery. The majority of SCIs are caused by traffic accidents and falling objects. The current global treatments used for SCI are surgical methods, steroid medications, physiotherapy, and spinal cord epidural stimulations. However, these approaches offer only temporary relief and have serious adverse effects. Various preclinical approaches have been studied for SCI, including biomaterials, drug delivery, electrical stimulation, and cell-based therapies. Among these, stem cell therapies, such as NSCs, MSCs, and iPSCs, have the potential to significantly improve axonal regrowth, reduce inflammation, and promote neuroprotection. Furthermore, biophysical stimulation methods such as optogenetics, electrical and mechanical stimulation, and biomechanical devices offer encouraging paths toward improving neural plasticity and functional recovery. However, combinational approaches such as biomaterials with cell-based systems, cell-based systems with drug delivery, and biophysical stimulation with biomaterials aim to have more significant potential for functional recovery than a single treatment alone. This review has discussed the current clinical practices for SCI treatment, their limitations, and combinational strategies for spinal cord regeneration. So, this article can give clinicians, bioengineers, and researchers clues to construct preclinical and clinical studies that can have long-term effects on patients.