Acute spinal cord injury (SCI) is a devastating condition that results in tremendous physical and psychological harm and a series of socioeconomic problems. Although neurons in the spinal cord need neurotrophic factors for their survival and development to reestablish their connections with their original targets, endogenous neurotrophic factors are scarce and the sustainable delivery of exogeneous neurotrophic factors is challenging. The widely studied neurotrophic factors such as brain-derived neurotrophic factor, neurotrophin-3, nerve growth factor, ciliary neurotrophic factor, basic fibroblast growth factor, and glial cell-derived neurotrophic factor have a relatively short cycle that is not sufficient enough for functionally significant neural regeneration after SCI. In the past decades, scholars have tried a variety of cellular and viral vehicles as well as tissue engineering scaffolds to safely and sustainably deliver those necessary neurotrophic factors to the injury site, and achieved satisfactory neural repair and functional recovery on many occasions. Here, we review the neurotrophic factors that have been used in trials to treat SCI, and vehicles that were commonly used for their sustained delivery.

Objective. Pedicle screw loosening is one of the main complications after pedicle screw fixation. However, there are few reliable measures for prediction of screw loosening. The current study was carried out to find an effective method to use preoperative CT scanning as a predictor of screw loosening in the elderly patients and provide guidance for preoperative surgical planning. Methods. Patients who were treated with lumbar pedicle screw fixation procedure in our department for degenerative lumbar disorders between January 2015 and January 2021 were retrospectively included in the current study. CT scan attenuation of each vertebra was measured with Hounsfield units (HU). Screw loosening was determined in postoperatively X‐ray tests. One‐way analysis of variance (ANOVA) and receiver operating characteristic (ROC) curve analysis were carried out with IBMSPSS 24.00 software. Results. Screw loosening was observed in 44 of 215 patients (124 male, 91 female, average age 58.4 ± 7.6 years) during a mean follow‐up time of 19.0 ± 11.2 months (range 12‐32 months). No significant differences were found among the patients concerning patient gender, BMI, habit of smoking, and whether or not the patient had diabetes or suffered from spondylolisthesis (P > 0.05). The average HU value of lumbar vertebra was 122.4 ± 32.8 HU in the screw loosening group and 142.4 ± 38.2 HU in the control group, and the difference was significant (P < 0.01). ROC curve analysis revealed that the average HU value of L1‐L5 has a relatively larger area under the curve (AUC) of 0.689 (95% CI: 0.605‐0.773). With the sensitivity of 68% and specificity of 57%, a HU cut‐off value of ≤124 HU is a plausible cut‐off point to predict screw loosening. Conclusions. A prospective CT scan HU value‐based prediction can be used to decide whether or not to use screw augmentation methods. A cut‐off L1‐L5 average HU value of 124 HU can be used as an independent risk factor for screw loosening in instrumented lumbar vertebra. More predictive indexes should be involved to achieve higher sensitivity and specificity in future clinical practice.

Objective: Because of the evolving nature of tissue engineering scaffolds in the treatment of spinal cord injury (SCI), the current study was carried out to evaluate the research productivity of tissue engineering scaffolds in the treatment of SCI. Methods: Studies published from 2000 to 2025 were retrieved from the Web of Science core collection with topics of spinal cord injury and tissue engineering scaffolds. The data were analyzed and visualized using the VOSviewer network analysis software. Results: Among 1542 articles analyzed, annual publications surged from 2000 to 2019, stabilizing thereafter. The U.S., China, and Canada led in productivity, with Northwestern University and the Biomaterials journal being top contributors. Keyword analysis revealed research hotspots such as functional recovery, axonal regeneration, stem cells, and hydrogels. Notably, hydrogels embedded with genetically engineered cells emerged as a pivotal trend, reflecting a shift toward biomimetic and combinatorial therapies. Collaboration networks highlighted intensified partnerships between Chinese and North American institutions, signaling global interdisciplinary efforts. Conclusions: This study provides the first bibliometric roadmap for tissue engineering scaffolds in SCI, identifying key trends, influential entities, and underexplored areas. The rise in hydrogels and international collaborations underscores opportunities for targeted research. These findings guide researchers in prioritizing high-impact journals, fostering partnerships, and advancing novel scaffold designs to bridge translational gaps in SCI treatment.

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