Extracellular matrix-modified helix-flexible nerve conduit with optimal mechanics and nerve regenerating properties.

Autologous nerve grafting remains the gold standard for peripheral nerve repair, yet its clinical application is limited by donor scarcity and secondary damage. This study aimed to develop a tissue-engineered nerve graft with optimal mechanical properties and bioactivity. By integrating an extracellular matrix derived from human umbilical cord mesenchymal stem cells with helical-structured nerve conduits, we successfully constructed a novel composite conduit. This conduit demonstrated exceptional kink resistance and compressive strength, enabling adaptation to dynamic mechanical environments such as transjoint regions. Furthermore, the ECM modification provided a highly biocompatible microenvironment that significantly promoted Schwann cell proliferation, angiogenesis, and axonal regeneration. In a rat sciatic nerve defect model, the conduit achieved key outcomes-functional recovery, electrophysiological performance, and axonal regeneration density-comparable to those of autografts. This work presents an innovative therapeutic solution with significant clinical translational potential for repairing long-segment and complex nerve defects spanning anatomical joints.