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  4. Advances in Spinal Regenerative Therapies Neuroplasticity and regeneration after spinal cord injury

Advances in Spinal Regenerative Therapies Neuroplasticity and regeneration after spinal cord injury

North American Spine Society Journal (NASSJ), 2023 · DOI: https://doi.org/10.1016/j.xnsj.2023.100235 · Published: June 8, 2023

Spinal Cord InjuryRegenerative MedicineNeuroplasticity

Simple Explanation

Spinal cord injury (SCI) is a serious condition that can lead to significant personal, social, and economic challenges. The most common type of traumatic SCI occurs in the neck area, resulting in major sensory, motor, and autonomic problems. Following the initial injury, further damage can occur due to inflammation and other processes that cause neuronal and glial cell death. Additionally, spinal interneurons can undergo changes that can either help or hinder functional recovery. Current treatments include early surgery, blood pressure management, and rehabilitation. Researchers are also exploring neuroregenerative strategies such as using neural stem cells, stem cell transplantation, combinatorial approaches, and cell reprogramming to enhance tissue repair after SCI.

Study Duration
Not specified
Participants
Not specified
Evidence Level
Review

Key Findings

  • 1
    Spinal interneuron reorganizations are subtype specific and may be adaptive or maladaptive for a given functional output.
  • 2
    Spinal interneuron subtypes may adopt new functional roles post-SCI that were not evident in the uninjured spinal cord.
  • 3
    Task-specific therapeutic targeting can significantly enhance adaptive spinal interneuron reorganizations and functional improvements post-SCI.

Research Summary

This review summarizes the key advances in the field of neural regeneration and neuroplasticity. Regenerative medicine shows promise to help enhance tissue regeneration following SCI, with various cellular and noncellular strategies being tested in the preclinical phase and through clinical trials. Furthermore, assessing combinatorial regenerative approaches with current standard of care guidelines will be important to target various aspects of secondary injury in order to improve sensorimotor functional recovery and enhance patient quality of life following SCI.

Practical Implications

Personalized Treatment Options

Further optimization of regenerative strategies will lead to standardized personalized treatment options for SCI patients.

Combinatorial Approaches

Combining regenerative approaches with current standard of care guidelines will target various aspects of secondary injury, improving sensorimotor functional recovery.

Improved Patient Quality of Life

The advancements in regenerative medicine aim to enhance patient quality of life following SCI.

Study Limitations

  • 1
    The review focuses on cutting-edge strategies, potentially overlooking established but less innovative approaches.
  • 2
    The discussion of interneuron plasticity is primarily focused on locomotor recovery and dysfunction, possibly neglecting other functional outcomes.
  • 3
    Clinical translation of many regenerative therapies is still in early stages, with ongoing challenges in optimization and standardization.

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