Medicinal, Psychological, and Health Research Journal (MPHRJ)

Abstract Spinal cord injury (SCI) results in extensive neural tissue damage and significant functional deficits, representing a major challenge in neuroscience and rehabilitation medicine. Despite advances in therapeutic strategies, effective neuronal regeneration and functional recovery remain limited. Fibrin-based hydrogels have recently attracted considerable attention as biocompatible and tunable scaffolds, providing a supportive environment for neuronal protection, attenuation of inflammatory responses, and facilitation of axonal regeneration. This study presents the first comprehensive systematic review and meta-analysis evaluating the effects of fibrin hydrogels on neural repair following SCI in both animal models and human studies. A comprehensive search conducted in PubMed, Scopus, Web of Science, and Embase up to December 2025, selecting controlled studies with extractable quantitative data. Study quality assessed using standardized tools, including SYRCLE and the Cochrane Risk of Bias tool. Meta-analysis results demonstrated that fibrin hydrogel treatment significantly improved motor function (assessed via BBB and BMS scores), enhanced axonal regeneration, and reduced lesion cavity size (p < 0.01). Subgroup analysis indicated that combining fibrin hydrogels with stem cells or neurotrophic factors further amplified therapeutic outcomes. Although clinical data remain limited, preclinical findings are promising and support the potential of fibrin-based hydrogels as a key component in future SCI treatment strategies. Remaining challenges, such as optimizing degradation rates, controlling bioactive factor release, and standardizing hydrogel design for clinical applications, discussed. Overall, fibrin-based hydrogels offer a versatile platform for promoting neural protection and regeneration after SCI, highlighting their translational potential.