Upper limb recovery after cervical spinal cord injury: A narrative review

Abstract

Cervical spinal cord injury presents significant challenges in restoring motor function, particularly of the upper limbs, which are essential for daily activities and independence. Recent advances in neural stem/progenitor cell technologies have shown promise for restoring damaged neural circuits and improving hand function. However, clinical and preclinical evidence indicate that stem cell transplantation alone is often insufficient for optimal recovery, and the mechanisms by which rehabilitation can enhance stem cell integration and upper limb recovery after spinal cord injury remain poorly understood. Therefore, this review synthesizes current evidence on stem cell therapy and targeted rehabilitation and explores their combined potential to promote circuit reorganization and functional recovery. We discuss key developments in neural stem/progenitor cell applications, including optimal timing and delivery methods, alongside targeted rehabilitation approaches, such as task-specific training and environmental enrichment. By integrating findings across regenerative strategies and rehabilitative approaches, this review emphasizes the need for a multimodal approach that combines cellular therapies with effective rehabilitation protocols to overcome the inherent challenges of cervical spinal cord injury. Ultimately, this comprehensive perspective aims to guide future research and clinical practices, paving the way for improved outcomes for individuals living with cervical spinal cord injury.