Spinal cord injury

Spinal cord injury represents a great health and economic burden for patients and society, and a major challenge for both the physician and the researcher. Following a lesion, a series of anatomopathological changes (glial scar formation, neuroinflammatory reactions, and cell death) occurs, associated with the poor capability of the adult CNS to restore its connectivity owing to an environment that inhibits axonal growth and the subsequent inactivation of the growth program. Some reorganization of local neural circuits and sprouting of axons can occur, and different therapeutic approaches are being tested in the early and delayed phases of disease by preventing glial scar formation, removing inhibitory molecules, or stimulating axonal growth by trophic factors, inducing physical exercise. In addition, cell therapy may be used to replace and restore lost neural circuits or to modulate the environment, as well as different types of scaffold. Finally, gene therapy could enhance axonal growth.