Acute Implantation of a Bioresorbable Polymer Scaffold in Patients With Complete Thoracic Spinal Cord Injury: A Randomized Controlled Trial (INSPIRE 2.0)

Neurosurgery 96:751–762, 2025

The INSPIRE 2.0 trial evaluated the safety and efficacy of a bioresorbable polymer scaffold for treating thoracic spinal cord injury. The study concluded that the scaffold did not provide a probable clinical benefit, leading to the trial’s early termination due to lack of efficacy and funding issues.

• The study INSPIRE 2.0 assessed the safety and potential benefit of a bioresorbable polymer scaffold (Neuro-Spinal Scaffold) in patients with complete thoracic spinal cord injury (SCI).

• Conducted as a randomized controlled trial at Level I trauma centers in the U.S., the study compared NSS implantation with standard-of-care spine surgery.

• The primary endpoint was the proportion of patients with an improvement of ≥1 AIS grade at 6 months post-surgery.

• Results showed no significant benefit of NSS over standard surgery; 20% of NSS patients improved compared to 30% of control patients.

• The study was terminated early due to not meeting its primary endpoint and subsequent withdrawal of industry sponsorship.

• Safety events were mostly mild or moderate, with no serious adverse device effects reported.

• The study highlighted the challenges of conducting clinical trials on spinal cord injury and the importance of reporting negative results.