Combining Therapeutic Strategies to Treat the Injured Spinal Cord: A Translational Perspective

Spinal cord injury (SCI) results in an array of debilitating, sometimes permanent-and at times life-threatening-motor, sensory, and autonomic deficits. A broad range of therapies have been tested pre-clinically, and there has been a significant acceleration in recent years of clinical translation of potential treatments. However, it is widely appreciated among scientists and clinical professionals alike that there likely is no "silver bullet" (single treatment) that will result in complete functional restoration after SCI. The combination of more than one treatment approach, especially treatments that can have distinct beneficial effects, increases the probability of functional improvement. This review highlights the mounting interest in the pre-clinical development and application of combination strategies to treat SCI, and some of the translational efforts made to combine promising therapies for clinical evaluation. Special attention is given to barriers and limitations faced in translating treatments for people living with SCI.