Year: 2026 | Month: November | Volume: 13 | Issue: 11 | Pages: 7-21
DOI: https://doi.org/10.52403/ijrr.20261102
Stem Cell–Based Therapies for Spinal Cord Injury: Biology, Evidence, Clinical Status, and Future Directions
Jevon Indra Susanto1, Thea Gianina Tjandra1, Cindy Thiovany Soetomo1, Tjokorda Gde Bagus Mahadewa1
1Department of Neurosurgery Udayana University/ Prof I.G.N.G Ngoerah Hospital, Denpasar, Indonesia
Corresponding Author: Jevon Indra Susanto
ABSTRACT
Spinal cord injury (SCI) causes permanent neurological disability through primary mechanical damage followed by secondary cascades involving inflammation, demyelination, vascular disruption, and glial scarring. Because standard care rarely restores lost neural circuitry, stem cell–based therapies have emerged as promising regenerative strategies. This review summarizes the biological rationale, major cell sources, mechanisms of action, preclinical evidence, clinical status, and future directions of stem cell therapy for SCI. Cell platforms discussed include embryonic stem cell-derived oligodendrocyte progenitor cells, induced pluripotent stem cell-derived neural stem/progenitor cells, mesenchymal stromal/stem cells, Schwann cells, and olfactory ensheathing cells. Across preclinical models, these therapies demonstrate neuroprotection, immunomodulation, remyelination, trophic support, and, in selected platforms, relay-like circuit reconstruction. Early clinical studies generally support short-term feasibility and acceptable safety, but efficacy signals remain heterogeneous and are limited by small cohorts, nonrandomized designs, variable rehabilitation exposure, and inconsistent manufacturing and delivery protocols. Emerging advances include combinatorial strategies integrating cells with biomaterials, extracellular matrix modulation, neuromodulation, and cell-free secretome or extracellular vesicle platforms. Overall, stem cell therapy for SCI is biologically compelling but not yet definitively efficacy-established. Progress toward clinical translation will require rigorous manufacturing, harmonized trial design, structured rehabilitation, mechanistic biomarkers, and long-term safety surveillance.
Keywords: Spinal cord injury; Stem cell therapy; Mesenchymal stromal cells; Induced pluripotent stem cells; Regenerative medicine.
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