A new study out of Australia is providing hope for spinal cord injury victims about the potential restoration of hand function. Researchers studied the effectiveness of nerve transfer on the ability for the hand and arm to receive restored function.
Spinal Cord Injury Statistics
Between 250,000 and 500,000 people suffer a spinal cord injury every year. The Australian rate for these injuries that inflict residents at least 15 years old is 11.8 individuals per million of the population. More than half of the spinal cord injuries in Australia occur at the cervical level, which often results in tetraplegia.
Cervical spinal cord injuries affect every aspect of the victim’s life and is associated with exorbitant medical costs. Individuals with this devastating condition often say that improvement in hand function is their primary goal.
About the Study
Nerve transfers have previously successfully been used to treat brachial plexus and peripheral nerve injuries, which inspired the study to see if this technique would be effective for individuals who had spinal cord injuries. Additionally, the current option to restore function is making tendon transfers out of donor muscles, which comes with a host of complications and the possibility of post-operational injuries.
The study began in 2013 when there was little published research regarding nerve transfer surgery for individuals who had tetraplegia. The research that had been conducted at the time was typically in the form of a case report, so the researchers’ study is the largest of its kind. It examined the clinical and functional outcomes of surgery of nerve transfer.
The study summarized information related to nerve transfers, which involve transferring a functioning donor nerve to a muscle above the spinal cord injury level to a nerve connected to a paralyzed muscle. The fibers of the nerve grow and make contact with the affected muscle in order to reanimate it. This process can take anywhere between three and nine months before the muscle is restored.
Study Findings
The nerve transfers in the study were used to reanimate the following functions
- Grasp
- Elbow extension
- Pinch and hand opening
The study found that nerve transfers provide an additional surgical option to help treat individuals with tetraplegia. According to the study, all patients received improvement in their clinical and functional outcomes at a rate similar to those who receive more complicated tendon transfers. No patient permanently lost function or went backward in their recovery. Adverse events were minimal. Patient satisfaction increased and said they would recommend the surgery to others.
The publication of the study has also made it more accessible to other surgeons who may consider the procedure as an alternative or additional possible treatment. Individuals who have C5 and below spinal cord injuries can discuss the feasibility of a nerve transfer in their particular situation with their doctor.
Benefits of Using Nerve Transfers
There are several benefits to using nerve transfers, including the following:
- Direct reanimation is possible with nerve transfers
- Nerve transfers are biomechanically designed to perform the related function
- Patients can receive more areas of reconstruction with nerve transfers
- Nerve transfers can reanimate more than one muscle to restore multiple functions at the same time
- A smaller surgical incision is necessary to complete the procedure
- Less splinting or immobilization follows the surgery
- There is less recovery time
- More donor nerves are available than other donor parts for alternative treatment
- Nerve transfers are less complicated than tendon tensioning
- There is less likelihood for post-operational injuries or complications
Next Research Steps
There were limitations to the study. For example, it is not known whether function and power continue to see improvement beyond the two-year mark. It may also be possible to integrate enhanced patient selection in order to realize even greater results. Additional research on connections between clinical and spinal cord injury factors and outcomes is necessary to better select patients for this type of surgery. Medical professionals may be able to combine tendon transfers and nerve transfers to optimize results. Communication between medical providers who are treating a patient with tetraplegia can further enhance the outcomes for patients when different interventions are combined together. A current project that examines the histological morphology of the affected nerves is currently being conducted, which will provide greater insight on the changes in the nerves that occur.
Legal Help for Spinal Cord Injury Victims
Spinal cord injuries are often the result of personal injury accidents, such as automotive accidents, slip and fall cases and medical malpractice. They can also occur from participation in sports or intentional violent actions. When a person suffers a spinal cord injury, his or her life may drastically change as the victim experiences limitations that were never imposed on him or her before, such as a lack of mobility and a higher need for the assistance of others. Additionally, medical treatment is ongoing and expensive. An experienced personal injury lawyer can review the options for a person who has suffered a spinal cord injury due to the actions of others. Contact our knowledgeable legal team today and request a free consultation to discuss your options.
