Two years after surgery, and following intensive physical therapy, the patients were able to reach their arm out in front of them and open their hand to pick up and manipulate objects as well as propel their wheelchair and transfer into bed or a car. They can now perform everyday tasks independently, including feeding themselves, brushing teeth and hair, writing, and using tools and electronic devices.
While it was only a small study, the researchers have seen enough to suggest nerve transfers could achieve similar functional improvements to traditional tendon transfers, with the benefit of smaller incisions and shorter immobilisation times after surgery.
"For people with tetraplegia, improvement in hand function is the single most important goal," says research leader Natasha van Zyl, from Austin Health in Melbourne. We believe that nerve transfer surgery offers an exciting new option, offering individuals with paralysis the possibility of regaining arm and hand functions to perform everyday tasks, and giving them greater independence and the ability to participate more easily in family and work life."
The study recruited 16 adults (average age 27 years) with traumatic, early (less than 18 months post injury) spinal cord injury to the neck (C5-C7), who were referred to Austin Health for restoration of function in the upper limb. Most were the result of motor vehicle accidents or sports injuries. All underwent single or multiple nerve transfers in one or both upper limbs to restore elbow extension.
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