Journal
TOPICS IN SPINAL CORD INJURY REHABILITATION
Volume 24, Issue 3, Pages 275-287Publisher
THOMAS LAND PUBLISHERS, INC
DOI: 10.1310/sci2403-275
Keywords
nerve transfer; tendon transfer; tetraplegia; spinal cord injury; upper extremity
Categories
Funding
- Craig H. Neilsen Foundation Spinal Cord Injury Research on the Translation Spectrum (SCIRTS)
- Department of Defense office of the Congressionally Directed Medical Research Programs (CDMRP) Fiscal Year 2016 Spinal Cord Injury Research Program (SCIRP) Investigator-Initiated Research Award [SC160046 : W81XWH-17-1-0285]
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Background: Recent adaption of nerve transfer surgery to improve upper extremity function in cervical spinal cord injury (SCI) is an exciting development. Tendon transfer procedures are well established, reliable, and can significantly improve function. Despite this, few eligible surgical candidates in the United States undergo these restorative surgeries. Evidence Acquisition: The literature on these procedures was reviewed. Results: Options to improve Function include surgery to restore elbow extension, wrist extension, and hand opening and dosing Function. Tendon transfers are reliable and well tolerated but require weeks of immobilization and limits on extremity use. The role of nerve transfers is still being established. Early results indicate variable return of meaningful function with less immobilization but longer periods (up to years) required to gain appreciable function. Conclusion: Nerve and tendon transfer surgery sacrifice an expendable donor to restore a missing and more critical function. These procedures are well described in hand surgery; are reliable, well tolerated, and covered by insurance; and should be part of the SCI rehabilitation discussion.
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