Mechanism of action of extracellular vesicles loaded with biomaterials in repairing spinal cord injury

• Exosomes combined with biomaterials enhance targeted delivery and therapeutic efficiency for spinal cord injury repair. • The combination regulates neuroinflammation, promotes axonal regeneration, and alleviates oxidative stress. • Biomaterials provide structural support and anti-inflammatory properties, overcoming limitations of exosome therapy alone. • Current evidence is limited to preclinical studies; clinical trials are needed to validate efficacy and safety.