Biomaterials for spinal cord injury repair: Advances and Challenges-A review

Spinal cord injury (SCI) represents a severe traumatic condition of the nervous system, often resulting in ongoing neurological impairment that profoundly impacts patients' quality of life. Conventional therapeutic approaches (including surgical decompression, medication and rehabilitation training) have demonstrated limited efficacy in promoting nerve regeneration, while recent advances in biomaterials research have provided a new treatment paradigm for this disease. This review systematically explains the application forms and major advancements of biomaterials in SCI repair. It focuses on analyzing the structural characteristics and functional advantages of natural polymers, synthetic polymers and composite materials. Additionally, it discusses the multifunctional roles of biomaterials as cell carriers, drug/factor delivery systems and physical scaffolds. The article provides a detailed introduction to the functional design strategies of biomaterial systems, including their innovative applications in actively regulating cells fate, controlling the release of bioactive molecules and reconstructing the electrical microenvironment. Meanwhile, it summarizes related preclinical studies and clinical trial progress, objectively evaluating the therapeutic effects and limitations of various biomaterial strategies. Although challenges remain in areas such as immune response control, standardized manufacturing and individualized treatment, through multidisciplinary collaboration, integrated therapeutic strategies based on biomaterials hold the potential to combine various treatment methods, overcome the multiple obstacles to spinal cord repair and regeneration and bring new hope for individuals suffering from SCI.