It is quite the understatement to say that quadriplegia – the partial or total loss of function of a person’s limbs and torso – is a life-changing disability. Often caused by a severe spinal cord injury, many patients remain unable to regain any use of their limbs for the rest of their lives. Now, a pioneering new study at the Washington University School of Medicine in St. Louis has managed to successfully restore some hand and arm movement to quadriplegics suffering from spinal cord injuries in the lower neck.
Whenever the spinal vertebrae are seriously damaged, branches of nerves cannot effectively transmit signals from the brain to the body’s muscles via the spinal cord, leading to partial or complete paralysis. The surgeons involved in this study have managed to reroute nerves in a several patients’ arms and hands, connecting still-healthy nerves to the damaged ones. In essence, this produces new nerve networks that allow for improved communication between the brain and the muscles in the limbs, allowing quadriplegics to once again move their arms and hands.
Although the restored movement is, so far, modest, the psychological benefit to the patients is astounding. “Physically, nerve-transfer surgery provides incremental improvements in hand and arm function. However, psychologically, these small steps are huge for a patient’s quality of life,” Ida K. Fox, the lead author of the study and assistant professor of plastic and reconstructive surgery, said in a statement. “One of my patients told me he was able to pick up a noodle off his chest when he dropped it. Before the surgery, he couldn’t move his fingers. It meant a lot for him to clean off that noodle without anyone helping him.”
At present, there is no cure for spinal cord injuries, but cutting-edge operating techniques such as the nerve redirection method used in this study restores the most basic functions to highly disabled people. This procedure was tested on several patients, including a primary care physician who was rendered a quadriplegic after a traffic accident; he is now able to feed himself with a fork, write using a pen and even drive.
One of the most undignified aspects of lower spinal cord damage is the loss of control over bladder or bowel functions. People are given catheters in cases such as this, but they have to rely on a carer to assist them. One of the subjects treated in the study who suffered from these problems can now catheterize himself.
Incredibly, this operation can be performed mere hours after the spinal cord injury has occurred; following four hours in surgery, and a night of recovery, most patients can go home the very next morning. After the operation, patients undergo six to 18 months of physical therapy designed to train the brain to recognize these new nerve networks. This technique is not only successful, it is efficient – and most importantly of all, it is transformative.
This remarkable study will be published this month in the American Society of Plastic Surgeons’ journal, Plastic and Reconstructive Surgery.