Advanced bio-adaptive hydrogels in spinal cord injury repair: from microenvironment remodeling to functional recovery

Abstract

Spinal cord injury (SCI) presents a huge clinical challenge in neurological repair and functional reconstruction. The advancement of regenerative medicine and neuroengineering technologies has positioned bio-adaptive hydrogels as an innovative therapeutic strategy for SCI treatment. Their controllable (bio)physicochemical properties, excellent biocompatibility, and ability to mimic the extracellular matrix (ECM) of the spinal cord allow them to effectively reshape the regenerative microenvironment, guiding the directional growth of neural axons and reconstructing nerve conduction pathways. Unlike previous reviews that focused on material synthesis or single-tissue repair, this article systematically elaborates on the multidimensional design strategies (e.g., biomechanical cues, enhanced conductivity, dynamic biological responses, and interfacial tissue adhesion) of bio-adaptive hydrogels for active regulation and rehabilitation of SCI. By summarizing recent research progress, we critically analyze the often-overlooked intrinsic connection between motor and bladder function repair, laying a theoretical foundation for achieving comprehensive functional recovery after SCI. Finally, recognizing the need for more intelligent and responsive therapeutic platforms, this article explores the emerging applications of artificial intelligence (AI) in the rational design and preparation of hydrogels, outlining a direction for the development of next-generation, AI-assisted smart hydrogels.