Spinal cord injury (SCI) is a serious problem that primarily affects younger and middle-aged adults at its onset. To date, no effective regenerative treatment has been developed. Over the last decade, researchers have made significant advances in stem cell technology, biomaterials, nanotechnology, and immune engineering, which may be applied as regenerative therapies for the spinal cord. Although the results of clinical trials using specific cell-based therapies have proven safe, their efficacy has not yet been demonstrated. The pathophysiology of SCI is multifaceted, complex and yet to be fully understood. Thus, combinatorial therapies that simultaneously leverage multiple approaches will likely be required to achieve satisfactory outcomes. Although combinations of biomaterials with pharmacologic agents or cells have been explored, few studies have combined these modalities in a systematic way. For most strategies, clinical translation will be facilitated by the use of minimally invasive therapies, which are the focus of this review. In addition, this review discusses previously explored therapies designed to promote neuroregeneration and neuroprotection after SCI, while highlighting present challenges and future directions. Impact Statement To date there are no effective treatments that can regenerate the spinal cord after injury. Although there have been significant preclinical advances in bioengineering and regenerative medicine over the last decade, these have not translated into effective clinical therapies for spinal cord injury. This review focuses on minimally invasive therapies, providing extensive background as well as updates on recent technological developments and current clinical trials. This review is a comprehensive resource for researchers working towards regenerative therapies for spinal cord injury that will help guide future innovation.

中文翻译：

---

脊髓损伤的再生疗法。

脊髓损伤（SCI）是一个严重的问题，主要在发病时影响年轻人和中年成年人。迄今为止，尚未开发出有效的再生疗法。在过去的十年中，研究人员在干细胞技术，生物材料，纳米技术和免疫工程学方面取得了重大进展，这些技术可能被用作脊髓的再生疗法。尽管使用特定的基于细胞的疗法的临床试验结果已被证明是安全的，但其功效尚未得到证实。SCI的病理生理学是多方面的，复杂的，尚待充分了解。因此，可能需要同时利用多种方法的组合疗法来达到满意的结果。尽管已经探索了生物材料与药物或细胞的组合，很少有研究以系统的方式结合这些方式。对于大多数策略，使用微创疗法将有助于临床翻译，这是本综述的重点。此外，本综述讨论了先前探索的旨在促进SCI后神经再生和神经保护的疗法，同时强调了当前的挑战和未来的方向。影响陈述迄今为止，尚无有效的疗法可在受伤后使脊髓再生。尽管在过去的十年中，生物工程和再生医学在临床前取得了重大进展，但这些进展尚未转化为有效的脊髓损伤临床疗法。这篇评论着重于微创疗法，提供广泛的背景以及最新技术发展和当前临床试验的更新。这篇综述是致力于研究脊髓损伤再生疗法的研究人员的全面资源，这将有助于指导未来的创新。