Natasha van Zyl et al successfully performed nerve transfers, restoring hand function and elbow extension among patients suffering from traumatic spinal cord injury. The research recruited 16 individuals with early (less than 18 months post-injury) cervical spinal cord injury. The patients had cervical spinal cord injury of motor level C5 and below. Surgeons performed single or multiple nerve transfers in one or both upper limbs by taking working nerves of expendable muscles and attaching them to nerves of paralyzed muscles. They also combined nerve transfers with tendon transfers in 10 patients. After surgery 13 participants showed improvements during the follow up at 24 months compared with baseline in total median scores for all primary outcomes including action research arm test (34.0 vs 16.5), grasp release test (125.2 vs 35.0), and spinal cord independence measure (39.3 vs 31.2). Mean grasp strength at 24 months was 3·2 kg in participants who underwent distal nerve transfers, 2·8 kg in those who had proximal nerve transfers, and 3·9 kg in those who had tendon transfers. The scientists conclude that nerve transfers may provide significant functional improvement in upper limb and hand function in patients with tetraplegia.
Source: The Lancet 2019; 4 July 2019 DOI: 10.1016/S0140-6736(19)31143-2. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31143-2/fulltext