Internal decompression of the acutely contused spinal cord: Differential effects of irrigation only versus biodegradable scaffold implantation

Guest, James D.; Moore, Sam; Aimetti, Alex A.; Kutikov, Artem B.; Santamaría, Andrea J.; Hofstetter, Christoph P.; Ropper, Alexander E.; Theodore, Nicholas; Ulich, Thomas R.; Layer, Richard T.

doi:10.1016/j.biomaterials.2018.09.025

Cited by 33 publications

(43 citation statements)

References 181 publications

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“…4). 6,132 In addition, they can support cell survival of delivered cells in situ, 44,50 as discussed later in this review, and recruit migrating endogenous cells, such as Schwann cells 121 and stem cells, 111,112,140 that can support regeneration. To avoid additional complexities associated with the use of cells, the use of acellular biomaterials for supporting spinal cord regeneration and remodeling after injury has been important to investigate.…”

Section: Reproduced Withmentioning

confidence: 97%

“…However, a biomaterial technology, the Neuro-Spinal Scaffold, has recently reached clinical trials. 52,120,121 Biomaterials used for the treatment of SCI can be in the form of conduits, 101,112,122 sheets, 123 scaffolds, 121,124 fibers, 125 particles, or hydrogels (Table 1). [126][127][128][129][130] Biomaterials are used to mechanically stabilize the injury site and provide an environment for interactions with host cells, physically fill SCI-associated cavities, reconstituting ECM, and bridging the injury to guide axonal growth across the gap.…”

Section: Reproduced Withmentioning

confidence: 99%

“…[126][127][128][129][130] Biomaterials are used to mechanically stabilize the injury site and provide an environment for interactions with host cells, physically fill SCI-associated cavities, reconstituting ECM, and bridging the injury to guide axonal growth across the gap. 70,101,112,121,[131][132][133][134][135] To guide axonal regeneration, several biomaterial architectures have been investigated, including channels, 86,[136][137][138] fibers, 139 scaffolds, and magnetic microgels. 58 Biomaterials for the treatment of SCI can also be used for the delivery of therapeutic agents and cells (Fig.…”

Section: Reproduced Withmentioning

confidence: 99%

“…To avoid additional complexities associated with the use of cells, the use of acellular biomaterials for supporting spinal cord regeneration and remodeling after injury has been important to investigate. 121,136,141,142 It is preferable that biomaterials be biodegradable and injectable for delivery through minimally invasive means. 70 In the acute phase of SCI, the use of a hydrogel is preferred as it may be used to seal the dura and release antiinflammatory drugs.…”

Section: Reproduced Withmentioning

confidence: 99%

“…For example, synthetic biomaterials with controlled properties and tailored degradation profiles can be functionalized with peptides, which are susceptible to degradation by cell-produced enzymes, 138,144 or provide sites for cell adhesion. 121,125 Several different types of scaffolds have been investigated for the treatment of SCI. A scaffold made of a block copolymer of PLGA and poly-l-lysine (PLL) with a highly interconnected porous structure (approximately 250-500-mmdiameter pores) was shown to lead to improved functional recovery after SCI in rats.…”

Section: Reproduced Withmentioning

confidence: 99%

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Regenerative Therapies for Spinal Cord Injury

Ashammakhi

Kim

Ehsanipour

et al. 2019

Tissue Engineering Part B: Reviews

121

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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.

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Section: Reproduced Withmentioning

confidence: 97%

Section: Reproduced Withmentioning

confidence: 99%

Section: Reproduced Withmentioning

confidence: 99%

Section: Reproduced Withmentioning

confidence: 99%

Section: Reproduced Withmentioning

confidence: 99%

See 3 more Smart Citations

Regenerative Therapies for Spinal Cord Injury

Ashammakhi

Kim

Ehsanipour

et al. 2019

Tissue Engineering Part B: Reviews

121

View full text Add to dashboard Cite

show abstract

Microenvironments‐Modulated Biomaterials Enhance Spinal Cord Injury Therapy

Li,

Zhang,

Liu

et al. 2024

Adv Funct Materials

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Spinal cord injury (SCI) results from various causes, including sports‐related incidents, degenerative cervical myelopathy, traffic accidents, and falls. SCI typically leads to sensory and motor dysfunction and even paralysis. Current treatments for SCI include systemic administration of high‐dose steroids and surgical decompression and stabilization. However, excessive use of glucocorticoids may increase susceptibility to infections and systemic bleeding. The long‐term effect of surgery intervention remains unclear, with ongoing debates regarding its timing, efficacy, and safety. Therefore, innovative approaches are urgently needed to alleviate secondary injuries and promote spinal recovery. One emerging therapeutic approach for SCI is modulating the microenvironments to achieve neuroprotection and neurogenesis during recovery. Several biomaterials with favorable physicochemical properties have been developed to enhance therapeutic effects by regulating microenvironments. This Review first discusses the pathology of SCI microenvironments and then introduces biomaterials‐based regulatory strategies targeting various microenvironmental components, including anti‐inflammation, anti‐oxidation, reduction of excitotoxicity, revascularization, neurogenesis, and scar density reduction. Additionally, the research and clinical application prospects for microenvironment regulation are presented.

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