Nanomedicine-enabled next-generation therapeutics for spinal cord injury

As a major challenge in neurological clinical practice, spinal cord injury (SCI) can occur in individuals of different ages and backgrounds, frequently leading to the loss of motor and sensory function. The intricate pathophysiology of SCI is responsible for the current lack of effective treatments to regenerate damaged neuronal cells and restore motor function. Primary mechanical injury to the spinal cord initiates a cascade of secondary damage, leading to a poor outcome for SCI patients. Despite some advances in supportive care for SCI, treatments that significantly improve neurological prognoses are urgently needed. Unfortunately, current clinical treatments, such as surgical decompression, rarely repair damaged nerves. Despite these challenges, however, the burgeoning development of nanotechnology and nanomaterials offers new hope. In this review, we comprehensively summarize recent advances in nanomaterial-enabled SCI treatment. First, the pathology and physiologic progression of SCI and its specificity are discussed. Thereafter, we systematically explore nanomaterial-initiated SCI therapies, including drug delivery systems, nano-biomaterials, and multifunctional nano-response systems, to facilitate neurological recovery after SCI. Finally, on the basis of the latest advancements, we conclude with insights into persistent challenges and delineate prospective developments in this rapidly emerging field. © 2025 Elsevier Ltd.