Open research questions in Spinal Cord Injury Research

What the literature leaves open

• The need for noninvasive, scalable alternatives to improve upper extremity function in individuals with tetraplegia. The lack of effective home-based interventions that can reduce barriers associated with lab-based interventions. The need for a randomized clinical trial to determine the effect of blood flow restricted exercise with and without transcutaneous spinal cord stimulation via telehealth.

  Blood flow restricted exercise with and without transcutaneous spinal cord stimulation via telehealth in persons with tetraplegia. A protocol for randomized clinical trial · 2026 · DOI

• There are notable discrepancies in the management of TSCI between high-income and low-and middle-income countries. The provision of care for TSCI is comparatively less organized and effective in developing countries. There is a lack of systematic and evidence-based initiatives to address the challenges in TSCI care in developing countries.

  Challenges in traumatic spinal cord injury care in developing countries – a scoping review · 2024 · DOI

• However, the effect of BES was only limited to the wrist extensor muscles without targeting the major upper extremity muscle groups.

  Blood flow restricted exercise with and without transcutaneous spinal cord stimulation via telehealth in persons with tetraplegia. A protocol for randomized clinical trial · 2026 · DOI

• The mechanisms of zinc ion treatment in spinal cord injury are not well understood. The role of IKBα in zinc ion treatment is not clearly defined.

  Zinc regulates microglial polarization and inflammation through IKBα after spinal cord injury and promotes neuronal repair and motor function recovery in mice · 2025 · DOI

• Lack of trained human resources. Insufficient public education. Delays in care delivery. Deficiencies in infrastructure and supportive legislation.

  Challenges in traumatic spinal cord injury care in developing countries – a scoping review · 2024 · DOI

• However, most studies have focused on high-intensity stimulation, while the key parameters underlying its therapeutic efficacy remain poorly understood.

  Pattern-dependent low-intensity repetitive magnetic stimulation enhances spinal cord repair through modulation of neuroinflammation · 2026 · DOI

• Menopause presents distinct medical and social challenges for women with spinal cord injury (SCI), yet little is known about the lived experiences of this population, in part due to gender bias in SCI research and care.

  A Narrative Inquiry Into the Menopause Experiences of Women With Spinal Cord Injury · 2026 · DOI

• Menopause presents distinct medical and social challenges for women with spinal cord injury (SCI), yet little is known about the lived experiences of this population, in part due to gender bias in SCI research and care.

  A Narrative Inquiry Into the Menopause Experiences of Women With Spinal Cord Injury · 2026 · DOI

• Abstract Objectives Spinal Cord Injury (SCI) severely impacts quality of life, yet consistent epidemiological data in Brazil are scarce.

  Epidemiological and etiological profile of spinal cord injury in Brazil: a systematic review and meta-analysis · 2026 · DOI

• This suggests potential therapeutic applications of zinc ions in SCI and other inflammatory conditions, warranting further investigation into their clinical benefits.

  Zinc regulates microglial polarization and inflammation through IKBα after spinal cord injury and promotes neuronal repair and motor function recovery in mice · 2025 · DOI

• BACKGROUND AND OBJECTIVES: Spinal cord injury (SCI) incidence is rising among the elderly, yet the relationship between age and recovery remains controversial.

  The Relationship Between Age and Recovery After Spinal Cord Injury · 2025 · DOI

• BACKGROUND AND OBJECTIVES: While preclinical studies documented potential neuroprotective effects of estrogen/progesterone, the impact of biological sex on outcomes after traumatic spinal cord injury (tSCI) remains incompletely understood.

  Effects of Biological Sex on Access to Care and Outcomes After Acute Spinal Cord Injury · 2025 · DOI

• However, the mitochondrial and cellular metabolic response during spinal cord regeneration remains unexplored.

  Xenopus laevis neural stem progenitor cells exhibit a transient metabolic shift toward glycolysis during spinal cord regeneration · 2025 · DOI

• However, only a few studies have examined the factors that influence participation systematically.

  Understanding factors influencing people with disabilities’ participation in sports and cultural activities · 2024 · DOI

• However, there are limited research on whether it has the potential to improve the prognosis of spinal cord injury.

  Teriparatide: an innovative and promising strategy for protecting the blood-spinal cord barrier following spinal cord injury · 2024 · DOI

• Although stem cell therapy holds promise for the treatment of spinal cord injury (SCI), its practical applications are limited by the low degree of neural differentiation.

  Electromagnetic Cellularized Patch with Wirelessly Electrical Stimulation for Promoting Neuronal Differentiation and Spinal Cord Injury Repair · 2024 · DOI

• While such incidence rates are high in chronic patients, the underlying mechanisms remain elusive.

  Nitric oxide-induced lipophagic defects contribute to testosterone deficiency in rats with spinal cord injury · 2024 · DOI

• Neural stem cell (NSCs) transplantation is a promising therapeutic strategy for spinal cord injury (SCI), but its efficacy is greatly limited by the local inhibitory microenvironment.

  Nitric Oxide-Releasing Mesoporous Hollow Cerium Oxide Nanozyme-Based Hydrogel Synergizes with Neural Stem Cell for Spinal Cord Injury Repair · 2024 · DOI

• Neutrophil membrane vesicles (NMVs) have been successfully applied to control the inflammatory cascade after spinal cord injury (SCI) by acting as an inflammatory factor decoy to front-load the overall inflammation regulatory window; however, the mechanisms by which NMVs regulate macrophage phenotypic shifts as well as their outcomes have rarely been reported.

  Biomimetic “Trojan Horse” Fibers Modulate Innate Immunity Cascades for Nerve Regeneration · 2024 · DOI

• In health systems and policy research, significant gaps in evidence-based practices were highlighted, emphasizing the need for comprehensive data collection and national registries to guide policy and align SCI care with global standards.

  Perspective of the World Rehabilitation Alliance: Global Strategies to Strengthen Spinal Cord Injury Rehabilitation Services in Health Systems · 2024 · DOI

• Caffeic acid phenethyl ester (CAPE), a compound extracted from propolis, has both anti-inflammatory and anti-oxidative effects, but its SCI therapeutic effects have rarely been reported.

  Caffeic acid phenethyl ester inhibits neuro-inflammation and oxidative stress following spinal cord injury by mitigating mitochondrial dysfunction via the SIRT1/PGC1α/DRP1 signaling pathway · 2024 · DOI

• Future studies can use the Thai version of the Barthel Index Self-Report to assess functional independence in Thai people with spinal cord injury. Future studies can also explore the use of the Thai version of the Barthel Index Self-Report in other populations, such as individuals with other types of disabilities.

  Validity and Reliability of the Thai Version of the Barthel Index Self-Report (BI-SR-TH) for People with Spinal Cord Injury · 2026 · DOI

• There was a need for a cross-culturally translated and validated Thai version of the Barthel Index Self-Report for Thai people with spinal cord injury. There was a lack of a reliable and valid tool for assessing functional independence in Thai people with spinal cord injury.

  Validity and Reliability of the Thai Version of the Barthel Index Self-Report (BI-SR-TH) for People with Spinal Cord Injury · 2026 · DOI

• The complexity of combinatorial strategies. The lack of long-term biocompatibility and safety profiles of nanomaterials. The regulatory hurdles of combination products.

  Comment on: advances in nanomaterial-based therapeutic research for spinal cord injuries: an overview · 2026 · DOI

• The development of next-generation smart systems with regulatory feasibility. The exploration of long-term biocompatibility and safety profiles of nanomaterials. The establishment of a more rational, staged model strategy.

  Comment on: advances in nanomaterial-based therapeutic research for spinal cord injuries: an overview · 2026 · DOI

Most-cited papers in Spinal Cord Injury Research

• A Randomized, Controlled Trial of Methylprednisolone or Naloxone in the Treatment of Acute Spinal-Cord Injury · New England Journal of Medicine · 1990 · 2,243 citations
• Administration of Methylprednisolone for 24 or 48 Hours or Tirilazad Mesylate for 48 Hours in the Treatment of Acute Spinal Cord Injury · JAMA · 1997 · 1,851 citations
• Spinal-cord injury · The Lancet · 2002 · 1,075 citations
• Walking naturally after spinal cord injury using a brain–spine interface · Nature · 2023 · 599 citations
• Activity-dependent spinal cord neuromodulation rapidly restores trunk and leg motor functions after complete paralysis · Nature Medicine · 2022 · 432 citations
• Exosomes‐Loaded Electroconductive Hydrogel Synergistically Promotes Tissue Repair after Spinal Cord Injury via Immunoregulation and Enhancement of Myelinated Axon Growth · Advanced Science · 2022 · 347 citations
• RECENT ADVANCES IN PATHOPHYSIOLOGY AND TREATMENT OF SPINAL CORD INJURY · AJP Advances in Physiology Education · 2002 · 262 citations
• Pathophysiology of spinal cord trauma · Annals of Emergency Medicine · 1993 · 213 citations
• Men, sport, spinal cord injury, and narratives of hope · Social Science & Medicine · 2005 · 195 citations
• Cytosolic phospholipase A2 in infiltrating monocyte derived macrophages does not impair recovery after spinal cord injury in female mice · Scientific Reports · 2025 · 191 citations

Most recent work

• Spinal cord stimulation for upper limb motor function in people with chronic post-stroke hemiparesis: a feasibility trial · Nature Medicine · 2026
• Validity and Reliability of the Thai Version of the Barthel Index Self-Report (BI-SR-TH) for People with Spinal Cord Injury · Biomedical Sciences and Clinical Medicine · 2026
• The Effect of Overground Locomotor Training on Self-Efficacy Following Spinal Cord Injury: An Exploratory Study · Occupational Therapy In Health Care · 2026
• Therapeutic effect and mechanism of pirfenidone in bladder fibrosis after spinal cord injury · European Journal of Pharmacology · 2026
• Health profiles, environmental barriers, and functional outcomes among individuals with spinal cord injury in Lebanon: A cross-sectional study · The Journal of Spinal Cord Medicine · 2026
• Exploring needs and perceptions about telemental healthcare among Veterans with spinal cord injuries, a qualitative study · Journal of Behavioral Medicine · 2026
• Can dual-task high-velocity exercise training improve cognitive function in older adults? Secondary analysis of an 18-month cluster randomized controlled trial · Age and Ageing · 2026
• Validating the ADFSCI hypotension symptom domain as a scalable patient reported outcome measure in spinal cord injury · npj Digital Medicine · 2026
• Identification of repopulated microglia-associated genes in microglia depleted/repopulated mice after spinal cord injury · Brain Research · 2026
• Trichosanthis peel injection improves functional recovery after spinal cord injury associated with the modulation of neuroinflammation and oxidative stress · Figshare · 2026

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