The role of polarization dynamics in macrophages and microglia on the inflammatory microenvironment of spinal cord injury.

Spinal cord injury (SCI) triggers complex pathological processes-including neuroinflammation, glial scar formation, and impaired neuronal regeneration-that hinder recovery. Macrophages and microglia centrally regulate these processes through dynamic polarization states across a spectrum of pro-/anti-inflammatory phenotypes. While single-cell technologies reveal glial and immune heterogeneity and interactions in the SCI microenvironment, translating these insights into immunomodulatory therapies remains challenging. This review therefore examines mechanisms driving macrophage/microglia polarization in the microenvironment of SCI, focusing on their therapeutic targeting potential.