• Exosomes, as natural nanocarriers, offer a promising cell-free therapeutic approach for spinal cord injury (SCI) repair due to their stability, biocompatibility, and low immunogenicity.
• The review systematically summarizes exosome isolation techniques, including ultracentrifugation, size-based methods, and microfluidics, highlighting the need for scalable production for clinical translation.
• Various exosome sources (e.g., mesenchymal stem cells) and administration routes are discussed, with evidence showing their potential to modulate inflammation, inhibit apoptosis, and promote axonal regeneration.
• Combining exosomes with other strategies, such as biomaterial scaffolds or drugs, may enhance therapeutic efficacy, but challenges like standardization and large-scale production remain.