Spinal cord injury

The spinal cord has a limited potential to regenerate after traumatic injury, due to extensive tissue destruction and a natural healing process, which creates physical, cellular, and molecular barriers in an attempt to preserve residual function. In this chapter, we focus on tissue-engineering approaches that use biomaterials as combinatorial therapies for spinal cord injury (SCI) repair. SCI is first described as the disruption of anatomic organization, along with its clinical and epidemiological consequences. Key tissue-engineering principles to facilitate spinal cord regeneration using biomaterial platforms in multimodal approaches are discussed. Bioengineering considerations for material fabrication in macro- and microarchitectures, and for integrated biocompatibility in animal models of SCI are addressed. The applications of natural and synthetic polymer scaffolds with cellular and molecular functionalization, and their outcomes in regenerating spinal cord tissue after injury, are presented in detail. The chapter concludes with perspectives on the clinical translation of these technologies to improve neurologic function in patients with SCI.