Background and
Objectives: Mechanical injury of the spinal cord triggers a secondary
complex long-term interplay of neural and vascular damage that obstructs neural
regeneration and aggravates functional outcomes. Inherent vascular responses
are often insufficient however; regulation of local revascularization pathways
has shown promising potential in vascular and axonal restitution. This review
delves into the pathophysiology of secondary processes and targeting approaches
and highlights the advancements of angiogenesis in spinal cord injuries (SCI).
The systematic review synthesizes research focusing on therapeutic innovations
of vascular regeneration enhancement, providing the neuroprotective role of the
vascular system and the potential of axonal regeneration.
Methods: This
review summarizes the complex processes of the mechanical impact aftermath and
the beneficial role of angiogenesis. The systematic search, according to PRISMA
guidelines, was conducted by two observers in established MEDLINE databases.
Included studies consisted of original research focusing on revascularization
after SCI without time limitation. Literature or systematic reviews and
non-English articles were excluded.
Results: After
applying specific selection criteria, 113 studies were identified for providing
original insights targeting angiogenesis in SCI. Typically, innate vascular
response and endogenous angiogenesis are inadequate to confront the
exacerbating inflammatory proliferation and vascular and neural disruption.
Recent advancements and therapeutic innovations aim to enhance the angiogenic
process mostly through augmentation of angiogenesis with proangiogenic factor
administration or delivery through biomaterial. Moreover, genetic modulation,
stem-cell therapies, and physical stimulation have shown promising results in
improved vascularization and axonal recovery.
Conclusion:
Spinal cord injuries prompt a critical need for treatments targeting vascular
repair and blood-spinal cord barrier stabilization to support recovery.
However, challenges persist in translating these strategies into clinical
outcomes, primarily because of the incomplete understanding of the complex
pathophysiology of SCI. Improving vascularization is crucial for minimizing
secondary damage and promoting neural regeneration.
Author(s)details:-
Konstantinos
Tsivelekas
B' Department of Orthopaedics, KAT General Hospital of Attica, Greece.
Dimitrios Pallis
B' Department of Orthopaedics, KAT General Hospital of Attica, Greece.
Stavros Lykos
B' Department of Orthopaedics, KAT General Hospital of Attica, Greece.
Petros Nikolakakos
B' Department of Orthopaedics, KAT General Hospital of Attica, Greece.
Stamatios A.
Papadakis
B' Department of Orthopaedics, KAT General Hospital of Attica, Greece.
Please See the book
here :- https://doi.org/10.9734/bpi/mria/v2/246
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