Review of advances in electrospinning-based strategies for spinal cord regeneration

Spinal cord injury (SCI) is a devastating neurological condition, commonly leading to physical and mental deficiencies, pain, other complications, and even death. Most recently, neural tissue engineering (NTE) has fostered the improvement of nerve regeneration after severe SCI, presenting a promising potential in clinic application. Ideal biomaterial scaffolds are undoubtedly the primary focus of NTE, and electrospinning technique has been extensively explored for the design and development of engineered scaffolds for NTE application owing to its simple processing, wide applicability, and huge industrialization potential. Moreover, electrospun nanofibrous scaffolds commonly possess small diameter and high specific surface area compared to traditional microfibrous scaffolds, thus providing beneficial microenvironment. Importantly, the nanofibrous structure of electrospun scaffolds largely resemble the topographic and structural characteristics of native extracellular matrix (ECM), and can effectively promote cell adhesion, growth, migration, proliferation, and even neuronal differentiation, as well as ECM remodeling and neo-tissue regeneration. In this review, we firstly introduce the anatomy of spinal cord and pathological mechanism of SCI. Then, the recent advances in the fabrication and modification of electrospun nanofibrous scaffolds for SCI treatment are summarized. Recent innovative techniques for the generation of aligned nanofibrous scaffolds and 3D anisotropic nanofibrous scaffolds are highlighted. Furthermore, several advanced synergetic approaches by integrating bioactive ingredients, external electrical or magnetic stimulation, and cell therapy with electrospun nanofibrous scaffolds are reviewed. At the end of this review, the challenges and prospects of employing electrospinning-based strategies for the SCI treatment in clinics are deeply discussed and summarized.