Nerve transfer surgery restores the function of hand and elbow extension in fully paralyzed persons, says the new research. Few tetraplegic adults were able to do their tasks after this surgery, in experiments conducted by the researchers.
These adults were able to hold a drink, brush their teeth and perform other tasks. Despite the benefits, there are still some limitations to nerve transfer surgery. For optimum results, the surgeons perform surgery within 6-12 months of spinal injury.
Nerve transfer surgery on paralyzed patients
In this surgery, surgeons attach functioning nerves to damaged ones. After two years of physical therapy, it enabled the tetraplegic adults to move their arms. And they were also able to perform their daily tasks.
Tetraplegia is a state that causes partial or complete loss of all four limbs or torso. It can be due to any illness or an injury. Mostly there is a loss of both sensory and motor functions.
The nerve transfer can improve functions like those evidenced in tendon transfers. In tendon transfer surgery, muscles responsible for some other function are re-sited to work at the place of paralyzed muscles.
In some patients, surgeons did surgery in combination with a tendon transfer. Thus, enabling them to have the strength of nerve transfer in one hand. And that of tendon transfer on the other hand.
Nerve transfer regains motor control of hand and arm. And tendon transfer restores the power. The nerve transfer has failed in three persons. So, there is a need for more research to find the people best for this surgery.
By doing this, one can reduce the chances of failure. Previous case studies have indicated that nerve transfer is realistic and safe in paralyzed persons.
But this is the first cohort study that uses functional outcome measures. And, the first one to use combinations of nerve and tendon transfers.
This study engaged young adult with spinal cord injury to their neck. Most injuries were the result of vehicle accidents or sports injuries.
The surgeons did surgery on one or both upper limbs to restore, grasp, pinch, and hand opening. The surgery involved taking working nerves and linking them to the nerves of paralyzed muscles. It regains voluntary control of the paralyzed part.
For example, the surgeons selected the nerve intervening a muscle in the shoulder as a donor’s nerve. And they attached it to the nerve supplying the triceps that activates the muscles that extend the elbow.
In the same way, nerve transfer surgery has restored the hand function.
Later, the adults involved in study completed assessments. That was based on their level of independence related to daily activities.
These activities involve self-care, muscle power, grasp, and pinch strength, and hand opening. Two years after surgery, notable recovery was present in the hand’s ability to pick up and release several objects.
Before surgery, none of the young adults was able to score on the grasp or pinch strength tests. But two years later pinch and grasp strength were adequate to perform daily tasks.
How is this surgery beneficial?
Injury to the spinal cord can cause loss of functions of limbs. The damage can affect overall working capability. For tetraplegics, the main goal is to regain hand function. And nerve transfer surgery restores this function.
Nerve transfer requires bed rest for a shorter period in contrast to tendon transfer. As nerve transfer also avoids the technical problems related to tendon transfer. Hence it is a reliable therapy for tetraplegic people.