Using nerve transfer to restore prehension and grasp 12 years following spinal cord injury: a case report

Spinal Cord Series and Cases, 2018 · DOI: https://doi.org/10.1038/s41394-018-0067-6 · Published: February 19, 2018

Spinal Cord Injury Surgery Rehabilitation

Simple Explanation

Nerve transfer surgery, commonly used for hand function restoration after lower motor neuron damage, is explored as an option for individuals with cervical spinal cord injury (SCI) to improve hand function. A 34-year-old male, 12 years post-SCI, underwent nerve transfer surgery to restore hand function, specifically transferring a nerve to improve thumb and finger flexion. Post-surgery, he showed improvement and independence in hand function. The study suggests that nerve transfer surgery could be a valuable alternative to traditional methods like tendon transfer or neuroprostheses for individuals with SCI seeking to regain hand function.

Study Duration

4 years

Participants

A 34-year-old male with cervical SCI

Evidence Level

Level IV, Case Report

Key Findings

1
Nerve transfers can successfully restore volitional hand function even more than 10 years following SCI.
2
A single nerve transfer can restore multiple functions via reinnervation of multiple muscles.
3
The patient exhibited functional improvement in hand function at 4 years post-nerve transfer surgery.

Research Summary

This case report presents a 34-year-old male, 12 years post-cervical spinal cord injury, who underwent nerve transfer surgery to restore hand function. The surgery involved transferring a branch of the musculocutaneous nerve (brachialis) to branches of the median nerve, resulting in improved thumb and finger flexion independent of the tenodesis effect. The patient experienced significant improvements in activities of daily living and continued to exhibit functional gains 4 years post-surgery, suggesting the long-term benefits of nerve transfer surgery for restoring hand function in SCI patients.

Practical Implications

Improved ADL Independence

Nerve transfers have the potential to significantly improve ADL independence (such as feeding) and quality of life for people with cervical SCI.

Alternative to Tendon Transfer

Nerve transfer surgery is an effective alternative to tendon transfer and neuroprostheses for restoring hand function.

Long-term Functional Gains

Patients can experience continued improvement in hand function even years after nerve transfer surgery.

Study Limitations

1
Single case report limits generalizability.
2
Long-term follow-up required to fully assess recovery.
3
Need for studies to establish evaluation and suitability criteria for nerve transfer procedures.

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