Vascular-Written Neural Pathway: A Living Vascular Guide for Staged Spinal Cord Regeneration

This proposal reverses the conventional scaffold logic for spinal cord regeneration. Instead of requiring an artificial scaffold to prescribe the final axonal route, a sparse directional braid defines a permissive negative-space corridor in which perfusable microvessels may self-organize. After vascular continuity, oxygenation, barrier integrity, and safety pass predefined thresholds—the “perfusion license”—the resulting living vascular network becomes a provisional guide for subsequent neurite growth. The central proposition is: the scaffold constrains possibility; perfused vessels select the viable route; axons subsequently use that living route. The primary hypothesis is that a mature, perfusable vascular network formed first inside a sparse directional braid will improve subsequent neurite survival, longitudinal alignment, and crossing distance compared with the same structure without prior vascular maturation. This is an open, falsifiable, and unvalidated preclinical research hypothesis. It is not a clinical treatment, medical advice, manufacturing specification, or surgical protocol.