News ID: 128584
Published: 0256 GMT October 09, 2015

Surgeons restore hand, arm movement to quadriplegic patients

Surgeons restore hand, arm movement to quadriplegic patients

A pioneering surgical technique has restored some hand and arm movement to patients immobilized by spinal cord injuries in the neck, reported a new study at Washington University School of Medicine in St. Louis.

Like railroad switchmen, the focus is on rerouting passageways; however, instead of trains on a track, the surgeons redirect peripheral nerves in a quadriplegic's arms and hands by connecting healthy nerves to the injured nerves. Essentially, the new nerve network reintroduces conversation between the brain and the muscles that allows patients, once again, to accomplish tasks that foster independence, such as feeding themselves or writing with a pen, Science Daily said.

The researchers assessed outcomes of nerve-transfer surgery in nine quadriplegic patients with spinal cord injuries in the neck. Every patient in the study reported improved hand and arm function.

"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," said the study's lead author, Ida K. Fox, assistant professor of plastic and reconstructive surgery. "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."

Soft nerve bundles form the human spinal cord, which acts as the body's control tower by communicating to the brain physical activities both large and small. The cervical spinal cord, in the neck, is comprised of seven vertebra denoted as C1 through C7.

Since surgeons connect working nerves in the upper arms to a patient's damaged nerves in their arms and hands, the technique targets patients with injuries at the C6 or C7 vertebra, the lowest bones in the neck. It typically does not help patients who have lost all arm function due to higher injuries in vertebrae C1 through C5.

Bypassing the spinal cord, surgeons reroute healthy nerves sitting above the injury site, usually in the shoulders or elbows, to paralyzed nerves in the hand or arm. Once a connection is established, patients undergo extensive physical therapy to train the brain to recognize the new nerve signals, a process that takes about 6-18 months.

 

   
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Resource: Science Daily
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