A surgical technique has reportedly helped restore hand and arm movement in patients paralyzed as a result of spinal cord injuries in the neck.
Via the nerve-transfer surgical technique, surgeons bypass the spinal cord and reroute healthy nerves sitting above the injury site—usually the shoulders or elbows—to paralyzed nerves in the hand or arm. Once a connection is established, patients undergo physical therapy to train the brain to recognize the new nerve signals. This process takes about 6 to 18 months, as explained in a media release from Washington University in St Louis.
This technique, developed 25 years ago, was performed initially to restore movement in the extremities of patients who had injured peripheral nerves and lost the ability to move a foot or an arm. However, in the past 5 years, it has been used to help restore limited movement in patients with spinal cord injuries, the release continues.
In a study published in the journal Plastic and Reconstructive Surgery, researchers at Washington University School of Medicine in St Louis assessed the outcome of nerve-transfer surgery in nine quadriplegic patients with spinal cord injuries in the neck.
According to the study, all nine participants reported improved hand and arm function.
“The gains after nerve-transfer surgery are not instantaneous,” says Susan E. Mackinnon, MD, who developed the surgical technique and is the study’s first author, in the release.
“But once established, the surgery’s benefits provide a way to let individuals with spinal cord injuries improve their daily lives,” adds Mackinnon, director of the School of Medicine’s Center for Nerve Injury and Paralysis, and the Sydney M. Shoenberg Jr. and Robert H. Shoenberg Professor of Surgery.
The nerve-transfer operation can be performed even years after a spinal cord injury. It usually takes 4 hours, and most patients go home the next morning, according to the release.
However, the release explains, since surgeons connect working nerves in the upper arms to a patient’s damaged nerves in their arms and hands, the technique targets patients with injuries at the C6 or C7 vertebra—the lowest bones in the neck. It typically does not help patients who have lost all arm function due to higher injuries in vertebrae C1 through C5.
“While the surgery itself can be relatively straightforward, the decision-making is complicated,” Mackinnon explains in the release. “We want to encourage people with spinal cord injury to consider this option when so little is often offered or made available.”
[Source(s): Washington University in St Louis, EurekAlert]