Nerve transfers in a patient with asymmetrical neurological deficit following traumatic cervical spinal cord injury: simultaneous bilateral restoration of pinch grip and elbow extension. Illustrative case

Cervical spinal cord injuries can cause significant loss of motor function in the upper extremities. This study explores the use of nerve transfers to restore function in a patient with an asymmetrical injury. The study uses a combination of neurological exams, MRI, and EMG to identify which muscles can be restored with nerve transfers. They then perform nerve transfers to restore elbow extension and pinch grip in both arms simultaneously. The patient showed significant improvement in upper extremity function, especially with bilateral tasks, indicating that simultaneous bilateral nerve transfers can be beneficial in cases of asymmetrical spinal cord injury.

• 1
  Following nerve transfers, the patient regained M4 strength in the long head of the triceps brachii bilaterally, indicating successful restoration of elbow extension.
• 2
  The patient's flexor pollicis longus and deep flexor of the index finger recovered to M4 on the right and M3/M2 on the left, respectively, demonstrating improved pinch grip strength.
• 3
  The Capabilities of Upper Extremity Questionnaire (CUE-Q) scores significantly improved, with a 400% increase in bilateral arm functionality, highlighting the functional benefits of the nerve transfers.