N.N. Priorov Journal of Traumatology and OrthopedicsN.N. Priorov Journal of Traumatology and OrthopedicsВестник травматологии и ортопедии им. Н.Н. Приорова0869-86782658-6738Eco-Vector62985210.17816/vto629852ReviewsОбзорыReview ArticleCombined approaches to spinal cord injury therapyКомбинированные подходы лечения травмы спинного мозгаhttps://orcid.org/0000-0001-8784-3200DavletshinEldar F.ДавлетшинЭльдар Фанилевич
Russian Federation
eldar.davletschin@gmail.comhttps://orcid.org/0000-0001-8933-83479337-8690ShulmanIlya A.ШульманИлья Александрович
Russian Federation

MD

ilyashul@mail.ruhttps://orcid.org/0000-0002-9435-340X8569-9002MukhamedshinaYana O.МухамедшинаЯна Олеговна
Russian Federation

MD, Dr. Sci (Medicine), associate professor

д-р мед. наук, доцент

yana.k-z-n@mail.ruKazan (Volga Region) Federal UniversityКазанский (Приволжский) федеральный университетRepublic Clinical HospitalРеспубликанская клиническая больницаKazan State Medical UniversityКазанский государственный медицинский университет17022025150220253212812920104202402052024Copyright ©; 2025, Eco-VectorCopyright ©; 2025, Эко-Вектор2025Eco-VectorЭко-Векторhttps://eco-vector.com/for_authors.php#07https://journals.eco-vector.com/0869-8678/article/view/629852

Currently, regenerative medicine (cell therapy) or motor rehabilitation approaches are being used to overcome the consequences of spinal cord injury. However, the efficacy of these approaches at the preclinical research stage does not always translate into successful implementation in clinical practice. In particular, complete recovery from functional deficits caused by severe spinal cord injury is often not possible. In this context, the development of combined approaches based on cell transplantation and neuromodulation is needed to enhance the neuroregenerative effect. The addition of dosed motor training to the overall treatment plan and in the context of combined approaches may have a significant supportive effect. In this review, we focused on evaluating clinical trials that used combinations of different approaches to gain an understanding of the mechanisms underlying their therapeutic effects. Despite the positive therapeutic outcomes of combined approaches, further research is needed into the emerging cellular and molecular changes involved in the reorganisation of neuronal connections.

В настоящее время для преодоления последствий травмы спинного мозга используют подходы регенеративной медицины (клеточная терапия) или двигательной реабилитации. Однако эффективность данных подходов на этапе доклинических исследований не всегда приводит к их успешному внедрению в клиническую практику. В частности, полное разрешение функционального дефицита, вызванного тяжёлой травмой спинного мозга, зачастую не представляется возможным. В связи с этим для усиления нейрорегенераторного эффекта необходимо развитие комбинированных подходов, основанных на трансплантации клеток и нейромодуляции. Дополнительное применение дозированной двигательной нагрузки в общем лечебном плане и на фоне комбинированных подходов может оказать значительный поддерживающий эффект. В данном обзоре мы сосредоточились на оценке клинических исследований, в которых используются комбинации различных подходов, для раскрытия понимания механизмов, лежащих в основе их терапевтического эффекта. Несмотря на положительные терапевтические результаты со стороны комбинированных подходов, всё ещё предстоит продолжить исследования возникающих клеточных и молекулярных изменений, включённых в реорганизацию нейронных связей.

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