A cervical spinal cord injury is a life-changing injury that can affect anyone in a single stroke of misfortune. However, a pioneering surgical procedure is helping to undo some of the devasting damage spinal cord injuries can do, gifting people with complete paralysis the ability to write, draw, and freely move their hands once again.
Thirteen young adults with a loss of movement in all four limbs, known as tetraplegia, have successfully undergone a nerve transfer surgery, whereby doctors connect functioning nerves with injured nerves to restore power to their muscles.
As reported in the medical journal The Lancet this week, the procedure takes donor nerves that are still hooked up to the spinal cord above the region of injury – typically the nerve supplying the teres minor muscle in the upper arm and shoulder – and surgically reroutes it to the paralyzed muscle itself. With the aid of therapy, the end result is free movement in the hand and elbow once again.
Smaller case studies have previously shown that nerve transfer surgery could be a safe and suitable treatment for people with paralysis, however, this is the first time scientists have shown off the success of multiple nerve transfer surgeries. While their study is still on the small side, it offers hope for people living with tetraplegia and other forms of paralysis.
“For people with tetraplegia, improvement in hand function is the single most important goal. We believe that nerve transfer surgery offers an exciting new option, offering individuals with paralysis the possibility of regaining arm and hand functions to perform everyday tasks, and giving them greater independence and the ability to participate more easily in family and work life,” Dr Natasha van Zyl from Austin Health in Melbourne, who led the research, said in a press release.
The researchers rounded up 16 young adults who had recently experienced a traumatic spinal cord injury to the neck within the past 18 months, most of which were the result of car accidents or sports injuries. All in all, 59 nerve transfers were completed in the 16 participants, with 10 of the cases also receiving a tendon transfer to ease along the process. Four of the nerve transfers failed in three participants, demonstrating that this is still relatively unexplored territory for biomedical surgery. Nevertheless, after 24 months, 13 patients were left with remarkably well-functioning hand and elbow movement allowing them to carry out everyday tasks independently.
"We have shown that nerve transfers can be successfully combined with traditional tendon transfer techniques to maximize benefits," van Zyl said. "When grasp and pinch was restored using nerve transfers in one hand and tendon transfers in the other, participants consistently reporting that they liked both hands for different reasons and would not choose to have two hands reconstructed in the same way."
As you can see in the videos of the patients, below, the results speak for themselves.