Spinal cord repair: Progress towards a daunting goal

Research over the past decade has demonstrated that, under some circumstances, structural reorganization of the CNS, including the spinal cord, can occur after injury, raising hopes that spinal cord repair associated with functional recovery, although a daunting goal, may not be an unreachable one, This brief review discusses recent approaches to this problem: use of neurotrophins and the rerouting of axons within the transected spinal cord from white matter to gray matter through nerve grafts, and the transplantation of exogenous myelin-forming glial cells to spinal cord tracts in which myelin has been lost. Results available to date indicate that, in models mimicking some aspects of human spinal cord injury, these approaches may yield anatomical repair that is associated with partial restoration of physiological and behavioral function. Many important questions remain unanswered, Nevertheless, although the clinical goal of repairing spinal cords in humans is a very challenging one, results in animal models suggest that spinal cord repair is a realistic objective and provide a glimpse of what is likely to be a period of rapid progress.