{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T03:55:01Z","timestamp":1793073301849,"version":"4.5.0"},"reference-count":152,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Bioeng. Biotechnol."],"abstract":"<jats:p>Spinal cord injury (SCI) is a devastating condition that frequently results in permanent disability. Repair and functional recovery after SCI are hindered by the complexity of its pathophysiology and the inherent challenges of neural regeneration within the central nervous system. Despite decades of research aimed at elucidating its pathological mechanisms and developing effective strategies to promote axonal regeneration and circuit rewiring, successful therapeutic outcomes remain limited. Recent advances in bioactive materials and stem cell technology have shifted the research focus from solely stimulating corticospinal tract regeneration toward building intermediate neural networks to facilitate neural repair and circuit reconstruction. Concurrently, emerging technologies that modulate neural activity through physical modalities, such as electrical, magnetic, and ultrasonic stimulation, are rapidly evolving. Among these emerging strategies, several\u2014including stem cell therapy, biomaterial-based interventions, and electromagnetic stimulation\u2014have advanced to clinical trials, with some already entering clinical practice. This review summarizes the major contemporary strategies and research advances in SCI repair. It details the mechanisms and latest developments in stem cell and extracellular vesicle therapy, biomaterial applications, and neuromodulation techniques. Finally, it discusses future therapeutic directions and ongoing challenges in clinical translation.<\/jats:p>","DOI":"10.3389\/fbioe.2026.1870955","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T06:05:42Z","timestamp":1784095542000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Emerging strategies for spinal cord injury repair: stem cells, extracellular vesicles, biomaterials, and neuromodulation"],"prefix":"10.3389","volume":"14","author":[{"given":"Bing","family":"Wu","sequence":"first","affiliation":[{"name":"The Second School of Clinical Medicine, Zhejiang Chinese Medical University","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangchang","family":"Ying","sequence":"additional","affiliation":[{"name":"The Second School of Clinical Medicine, Zhejiang Chinese Medical University","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiayi","family":"Dou","sequence":"additional","affiliation":[{"name":"The Second School of Clinical Medicine, Zhejiang Chinese Medical University","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han","family":"Zhang","sequence":"additional","affiliation":[{"name":"The Second School of Clinical Medicine, Zhejiang Chinese Medical University","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The Second Affiliated Hospital of Zhejiang Chinese Medical University","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junwei","family":"Feng","sequence":"additional","affiliation":[{"name":"The Second School of Clinical Medicine, Zhejiang Chinese Medical University","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiale","family":"Zhang","sequence":"additional","affiliation":[{"name":"The Second School of Clinical Medicine, Zhejiang Chinese Medical University","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Binbin","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The Second Affiliated Hospital of Zhejiang Chinese Medical University","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lianguo","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The Second Affiliated Hospital of Zhejiang Chinese Medical University","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liqiang","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The Second Affiliated Hospital of Zhejiang Chinese Medical University","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingyuan","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The Second Affiliated Hospital of Zhejiang Chinese Medical University","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongcheng","family":"An","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The Second Affiliated Hospital of Zhejiang Chinese Medical University","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"89674","DOI":"10.5500\/wjt.v14.i1.89674","article-title":"Current status and future perspectives on stem cell transplantation for spinal cord injury","volume":"14","author":"Agosti","year":"2024","journal-title":"World J. 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