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Spinal cord injury research and national institutes of health funding: a call to action

Spinal Cord volume 64, pages 71–78 (2026)Cite this article

Subjects

Abstract

Study design

Cross-sectional study.

Objectives

The magnitude and nature of National Institutes of Health (NIH) funding for spinal cord injury (SCI) research is poorly characterized. This study elucidates the portfolio of NIH grants awarded for SCI research.

Setting

N/A

Methods

Data on NIH grants awarded for SCI research were extracted from the NIH RePORTER database (2013–2023). NIH funding was analyzed for twenty-five clinical areas and compound annual growth rates (CAGRs) were calculated over the study period.

Results

From 2013–2023, the NIH extramural research budget increased from $28.3 to $45.0 billion (CAGR 4.7%). A total of $986 million was awarded for SCI research, which increased from $93.6 to $97.7 million over the study period (CAGR 0.4%). Among the twenty-five clinical areas, dementia ($21.8 billion, CAGR 18.7%) and diabetes ($20.6 billion, CAGR 21.5%) had the most NIH funding. For SCI research, most NIH funding was awarded by the National Institute of Neurological Disorders and Stroke (67%) via the R01 (57%) grant mechanism. The clinical areas receiving the most NIH funding for SCI research were disease mechanisms (47%), prosthetics (22%), biologic therapies (18%), and pharmacologic therapies (6%). Several principal investigator characteristics were associated with higher NIH funding totals for SCI research including male (P < 0.001), full professor (P < 0.001), and MD, PhD degree (P = 0.044).

Conclusions

Growth in the annual NIH budget for SCI research has not kept pace with growth in the overall NIH extramural research budget. Future strategies are needed to support PIs in obtaining NIH grant funding for SCI research.

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Fig. 1: Total Annual National Institutes of Health Research Budget Relative to NIH Funding for Spinal Cord Injury Research.
Fig. 2: Specific Institutes Awarding the Most National Institutes of Health Funding for Spinal Cord Injury Research.
Fig. 3: Top Clinical Areas Receiving the Most National Institutes of Health Funding for Spinal Cord Injury Research.

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Data availability

Data sets generated in this study are available from the corresponding author upon reasonable request.

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Funding

None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript.

Author information

Authors and Affiliations

  1. Medical University of South Carolina, Charleston, SC, US

    Jason Silvestre, John C. Martin, Warren Roth, Robert J. Ferdon, Charles A. Reitman, James P. Lawrence & Robert A. Ravinsky

  2. University of Toronto, Toronto, CA, US

    Michael G. Fehlings

Authors
  1. Jason Silvestre
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Contributions

JS: study conception, data collection, data analysis, manuscript preparation/revision. JCM: manuscript preparation/revision. WR: manuscript preparation/revision. RJF: manuscript preparation/revision. CAR: manuscript preparation/revision. JPL: manuscript preparation/revision. MGF: manuscript preparation/revision. RAR: manuscript preparation/revision.

Corresponding author

Correspondence to Jason Silvestre.

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Competing interests

The authors declare no competing interests.

Ethical approval and consent to participate

All methods were performed in accordance with the relevant guidelines and regulations. This study qualified for review exemption status based on the policies of the Institutional Review Board. Informed consent was not necessary due to the de-identified nature of all data.

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Supplementary information

41393_2025_1156_MOESM1_ESM.docx

Supplemental Table 1. Description of National Institutes of Health Grant Mechanisms Awarded for Spinal Cord Injury Research

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Silvestre, J., Martin, J.C., Roth, W. et al. Spinal cord injury research and national institutes of health funding: a call to action. Spinal Cord 64, 71–78 (2026). https://doi.org/10.1038/s41393-025-01156-z

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