Nerve and Tendon Transfer Surgery in Cervical Spinal Cord Injury: Individualized Choices to Optimize Function

Topics in Spinal Cord Injury Rehabilitation
Ida K FoxCatherine M Curtin

Abstract

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 closing 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.

References

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Citations

Jul 13, 2018·Topics in Spinal Cord Injury Rehabilitation·Kevin L KilgoreP Hunter Peckham
Nov 19, 2019·The Journal of Hand Surgery, European Volume·James P Ledgard, Claudia R Gschwind
Aug 28, 2020·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Kristine M ChapmanJustin Yeung
Dec 16, 2020·Neurology India·Johnie O HodgeNicholas J Brandmeir
Nov 10, 2020·Korean Journal of Neurotrauma·Siew Khei LiewHyun Sik Gong
Jul 7, 2020·Physical Medicine and Rehabilitation Clinics of North America·Joshua A Vova, Loren T Davidson
Apr 25, 2021·BMC Neurology·Syena MoltajiJana Dengler
Jun 22, 2021·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Elspeth J R HIllThomas H Tung

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