Peripheral nerve transfers for dysfunctions in central nervous system injuries: a systematic review

International Journal of Surgery, 2024 · DOI: http://dx.doi.org/10.1097/JS9.0000000000001267 · Published: March 18, 2024

Neurology Surgery Rehabilitation

Simple Explanation

Nerve transfer surgery is being used in new ways to help people with problems caused by injuries to their brain and spinal cord. This surgery can help restore movement and feeling. By connecting working nerves to damaged areas, the surgery can create new pathways for signals in the nervous system. This can help the brain adapt and recover lost functions. This review looks at recent progress in using nerve transfers for conditions like spinal cord injury, stroke, traumatic brain injury, and cerebral palsy. It highlights how these surgeries, along with rehabilitation and new technologies, can improve patient outcomes.

Study Duration

January 1920 to May 2023

Participants

371 participants in the surgery group and 192 in the control group

Evidence Level

Systematic Review

Key Findings

1
For spinal cord injuries, nerve transfer can lead to an increase of 3.13 in the Medical Research Council grade for muscle strength.
2
In patients with unilateral brain injury, the Fugl-Myer motor assessment score improved significantly in the upper extremity compared to the control group, with improvements ranging from 15.14 to 26 points.
3
Nerve transfer techniques show promise in improving bladder control after spinal cord injury, with 15 out of 20 patients experiencing a reduction of more than 100 ml in residual urine volume.

Research Summary

This review summarizes recent advancements in nerve transfers for dysfunctions following CNS injuries, exploring rehabilitation strategies informed by enhanced insights into neural plasticity. The analysis included 35 studies (20 on SCI and 15 on brain injury) with 371 participants in the surgery group and 192 in the control group, showing improvements in sensorimotor functions and bladder control. The study concludes that nerve transfer generally improves sensorimotor functions in paralyzed limbs and bladder control following CNS injury, facilitating functional recovery through neural plasticity.

Practical Implications

Improved Motor Function

Nerve transfers can significantly improve motor function in patients with spinal cord and brain injuries, offering a more natural and precise control than traditional tendon transfers.

Enhanced Bladder Control

Nerve transfer techniques have shown promising results in restoring bladder control for patients with spinal cord injuries, improving their independence and quality of life.

Rehabilitation Strategies

Tailored rehabilitation strategies, combined with noninvasive brain stimulation techniques and neurorehabilitation technologies, are essential to maximize the benefits of nerve transfer and enhance recovery outcomes.

Peripheral nerve transfers for dysfunctions in central nervous system injuries: a systematic review

Simple Explanation

Key Findings

Research Summary

Practical Implications

Improved Motor Function

Enhanced Bladder Control

Rehabilitation Strategies

Study Limitations

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Was this summary helpful?

Peripheral nerve transfers for dysfunctions in central nervous system injuries: a systematic review

Simple Explanation

Key Findings

Research Summary

Practical Implications

Improved Motor Function

Enhanced Bladder Control

Rehabilitation Strategies

Study Limitations

Your Feedback

Was this summary helpful?