Chapter 31 Spinal cord injury: Bridging the lesion and the role of neurotrophic factors in repair

Abstract

Publisher Summary This chapter summarizes the progress that has been made in the field of spinal cord repair with special emphasis on studies dealing with bridging spinal cord lesions and inducing sprouting and long-distance regrowth of injured CNS axons. The various approaches as described in this chapter have resulted in important axonal ingrowth into the variety of implants used for transplantation in the lesioned spinal cord. Depending on the nature of the implant, many different neuronal cell types from the lesioned adult host animal are able to respond to grafting with sprouting and elongation of their injured axons. Real long distance regeneration across the transplant and into the distal parts of the lesioned spinal cord and the subsequent formation of functional synapses at the appropriate targets has not been reported yet. In conclusion, in the past few years important progress has been made considering stimulation of regrowth ( sprouting and elongation) of injured spinal cord fibres. Unfortunately, it is still unclear to what extent this regrowth is related to functional repair. Local compensatory mechanisms may account for some recovery of function after spinal cord injury and this may not be related to regrowth of specific long-distance tacts. In research on regeneration of the injured spinal cord at the anatomical level the stimulation of target selection, re-synaptogenesis and re-myelination are the major challenges for future research.