Spinal cord injury causes permanent loss of movement, sensation, and autonomic function below the injury level — and for decades, the belief that the spinal cord could not repair itself set a low ceiling on recovery expectations. New research is challenging that assumption with a wave of biological, device, and rehabilitation approaches.
What's actually going on in research
Epidural electrical stimulation delivered to the spinal cord below the injury level is enabling voluntary movement in people with previously "complete" injuries, and trials are scaling this approach and combining it with rehabilitation. Stem cell and gene therapy trials are attempting to bridge injured cord tissue with new cells and encourage axon regrowth. Anti-Nogo and other drugs targeting the molecular brakes that prevent nerve regeneration are in human trials.
Epidural spinal stimulation
Electrodes placed on the spinal cord below the injury can activate dormant circuits, enabling standing and in some cases walking. Large trials are testing optimal placement, parameters, and pairing with rehabilitation.
Cell-based repair
Schwann cells, oligodendrocyte precursors, and induced pluripotent stem cell-derived neurons are being transplanted into injury sites in early human trials to promote reconnection.
Anti-regeneration inhibitors
Drugs blocking proteins like Nogo-A that suppress nerve regrowth in the spinal cord are in human trials to see whether removing these molecular barriers restores function.
What to know before you search
Eligibility depends on injury level (cervical vs. thoracic), injury completeness (AIS classification), time since injury (acute vs. chronic), and prior rehabilitation.
What types of trials are currently open
- Device trials — Testing epidural spinal stimulators, brain-computer interfaces, and exoskeletons for motor recovery.
- Cell therapy trials — Evaluating stem cell transplantation, Schwann cell grafts, and other regenerative approaches.
- Drug trials — Testing neuroprotective drugs in acute injury and regeneration-promoting drugs in chronic injury.
- Rehabilitation trials — Comparing locomotor training, activity-based therapy, and technology-assisted rehabilitation intensities.
- Autonomic and quality of life trials — Testing treatments for bladder, bowel, blood pressure, and sexual function after spinal cord injury.
Recently added Spinal Cord Injury trials
Clinical Investigation to Validate the Safety and Performance of Integrating Functional Electrical Stimulation Into the ABLE Exoskeleton
The primary objective of this study is to validate the safety and clinical performance of the ABLE Exoskeleton with integrated Functional Electrical Stimulation (ABLE FES) in individuals with neurological conditions that impair gait, including spinal cord injury, acquired brain injury, and multiple sclerosis. The secondary objective is to collect preliminary data on the potential clinical and psychosocial benefits of combining robotic gait assistance with electrical stimulation.
NIRS MONITORING OF SPINAL CORD ISCHEMIA IN AORTIC SURGERY
This prospective observational study aims to evaluate the feasibility and clinical utility of near-infrared spectroscopy (NIRS) monitoring applied to paraspinal muscles as a surrogate marker of spinal cord perfusion in patients undergoing major noncardiac surgery. Spinal cord ischemia represents a rare but devastating complication, often difficult to detect in real time. NIRS provides a non-invasive, continuous monitoring of regional tissue oxygen saturation (rSO₂), potentially reflecting microcirculatory changes in paraspinal tissues and indirectly spinal cord perfusion. The study will enroll adult patients undergoing major surgery requiring advanced hemodynamic monitoring. NIRS sensors will be placed over paraspinal regions, and rSO₂ values will be continuously recorded throughout the perioperative period. Hemodynamic parameters, including arterial pressure, cardiac output, and other relevant clinical variables, will be simultaneously collected. The primary objective is to assess changes in paraspinal rSO₂ during perioperative management and their relationship with systemic hemodynamic variables. Secondary objectives include the evaluation of the association between rSO₂ variations and postoperative neurological outcomes, as well as the feasibility and reliability of this monitoring technique in routine clinical practice. This study may provide preliminary evidence supporting the use of NIRS as a bedside, non-invasive tool for early detection of impaired spinal cord perfusion and for guiding hemodynamic optimization strategies.
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