Spinal Cord Injury: Emergency Assessment, Multidisciplinary Management, Rehabilitation, and Long-Term Care-An Updated Review

Background: Spinal cord injury (SCI) is a cause of disability. It can produce motor, sensory, and autonomic dysfunction and affect bladder and bowel control, respiratory function, and well-being. The initial mechanical injury is followed by secondary processes, including ischemia, inflammation, oxidative stress, excitotoxicity, and tissue damage. Aim: This review examines the assessment and management of SCI, with attention to emergency care, pharmacological and surgical treatment, rehabilitation, nursing, long-term support, and regenerative strategies. Content: The review outlines spinal cord anatomy and the primary and secondary mechanisms of injury. It discusses the acute, subacute, intermediate, and chronic phases and considers treatment approaches aimed at limiting secondary damage, decompressing and stabilizing the spine, managing pain and spasticity, and preventing complications. The roles of rehabilitation, physical and occupational therapy, assistive devices, and psychosocial support are also addressed. In addition, the review summarizes tissue-engineering strategies using natural, synthetic, and hybrid biomaterials, as well as cell-based approaches involving neural stem or progenitor cells, mesenchymal stromal cells, dental pulp stem cells, oral mucosa stem cells, olfactory ensheathing cells, and induced pluripotent stem cells. Signaling pathways and mediators, including neurotrophic factors, inflammatory cytokines, chondroitin sulfate proteoglycans, and cyclic AMP, are considered in relation to neural survival and regeneration. Conclusion: SCI care requires coordinated acute treatment and sustained rehabilitation. Biomaterial scaffolds, cellular therapies, and molecular interventions offer routes to tissue repair, but most remain experimental and require further evaluation of efficacy, safety, and outcomes.