How tax structures for retail cannabis shape cannabis use among youth and young adults: evidence from a volumetric choice experiment.

Spinal cord injury (SCI) refers to structural and functional damage to the spinal cord caused by traumatic events (such as traffic accidents, falls from heights, and sports injuries) or non-traumatic factors (including tumor compression, vascular lesions, infectious diseases, and degenerative conditions) (Liu et al., 2024; Wand and Bai, 2024). This damage results in interruptions or abnormalities in the nerve conduction pathways between the brain and the body. SCI can lead to the loss of motor, sensory, and autonomic functions, with the specific impact on the patient depending on the location and severity of the injury (Deng et al., 2024). Clinical studies have shown that the higher the level of the injury (e.g., cervical injury), the worse the prognosis for the patient, potentially leading to serious consequences such as quadriplegia, respiratory dysfunction, and bowel and bladder control disorders (Hagen et al., 2011; Kandhari et al., 2022). In contrast, thoracolumbar injuries typically result in paraplegia and sensory loss in the corresponding segments (Tian et al., 2023). Importantly, patients with complete SCI are significantly less likely to recover function compared with those with incomplete injuries, suggesting the necessity of early and accurate assessment. As the population continues to grow, the total number of SCI cases is increasing each year. Notably, the most considerable rise in the incidence of SCI has been observed among older adults, largely due to the increased prevalence of osteoporosis and a higher risk of falls resulting from decreased balance in this population. Additionally, the in-hospital mortality rate for older adult patients with SCI remains high (Jain et al., 2015). Statistics indicate that the number of new SCI cases worldwide ranges from 250,000 to 500,000 each year. In China, the incidence of SCI is also rising annually and can affect individuals of all ages (Ning et al., 2011; Reinhardt et al., 2017). The multidimensional impact of SCI extends far beyond the medical context. Research shows that up to 80% of patients with SCI suffer from chronic pain, which severely affects their sleep quality and mental health (Dombovy-Johnson et al., 2020). Functionally, SCI leads to paralysis and bowel and bladder dysfunction, significantly reducing patients’ ability to care for themselves and placing considerable burdens on both society and their families. Furthermore, patients with SCI often require long-term treatment and rehabilitation, consuming vast resources and increasing the financial burden on their families, while also putting immense pressure on the social security system. Therefore, SCI is not only an individual health issue but also a major public health and socioeconomic challenge (Badhiwala et al., 2019; Karsy and Hawryluk, 2019; Widerström-Noga, 2023). Currently, traditional treatments for neurological dysfunction after SCI include medication, surgery, and rehabilitation (Tian et al., 2023; Izzy, 2024). However, all of these methods have considerable drawbacks and are often ineffective in controlling pain (Cragg et al., 2016). The primary purpose of surgical treatment is to reduce compression of the spinal cord and prevent secondary injury, but it is challenging to repair damaged nerve tissue (Klockner et al., 2023). Medications, such as hormones, may only be effective in the early stages of injury and have limited long-term efficacy in nerve recovery (Kupfer and Formal, 2022). In recent years, an increasing number of studies have shown that neuroregulation technologies, particularly spinal cord stimulation (SCS), remarkably improve neural function after SCI (Wu et al., 2025). By implanting electrodes to emit electrical pulses with specific parameters, SCS can promote the release of brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF), enhancing the plasticity of spinal cord nerves. SCS promotes the growth and repair of nerve axons, helping patients with SCI restore motor function, alleviate pain, and improve autonomic nerve function (Fong et al., 2009; Goganau et al., 2018; Hachmann et al., 2021; Bacova et al., 2022; Smeijers et al., 2022). Although SCS has been shown to aid in the recovery of neurological function after SCI, its specific mechanisms remain unclear. Existing studies still face challenges, including insufficient standardization of stimulation parameters, a lack of long-term efficacy data, and variability in clinical outcomes, which urgently need to be addressed through large-sample multicenter studies (Biktimirov et al., 2023; Sokal et al., 2024). Therefore, the purpose of this paper is to review the research progress on the role and mechanisms of SCS in treating chronic pain after SCI, explore potential molecular and circuit mechanisms in depth, and suggest directions for future research to provide new treatment methods for clinical practice and innovative ideas for follow-up studies.