Biomaterial-Based Emergency Intervention for Secondary Spinal Cord Injury

Timely therapeutic interventions for acute spinal cord injury (SCI) are critical for enhancing long-term neurological and functional outcomes by limiting injury progression. However, current clinical strategies, such as methylprednisolone (MS) shock therapy and spinal decompression surgery, often yield suboptimal results. Moreover, MS administration is linked to severe systemic side effects, including pneumonia and gastrointestinal bleeding, while determining the optimal timing for decompression surgery remains challenging. Therefore, developing innovative therapeutic approaches is essential. Biomaterials, with their advanced drug delivery capabilities and unique biochemical properties, modulate cell behaviors and regulate the microenvironments of injured spinal cord, offering a promising treatment avenue for acute SCI. This review highlights the dynamic changes in SCI tissue during the initial phases and examines cutting-edge biomaterial-based emergency interventions, including the limitation of inflammation, reduction of excitotoxicity, restoration of the blood-spinal cord barrier, and inhibition of scar formation. Additionally, it addresses the challenges and opportunities of translating these innovations from basic research to clinical practice, thereby guiding future developments in clinically viable biomaterials.