Pioneering Procedure

A surgical procedure pioneered at Washington University’s School of Medicine in St. Louis allowed quadriplegic patients to regain some hand and arm movements, according to a study published in the October issue of the American Society of Plastic Surgeons’ journal Plastic and Reconstructive Surgery. The technique involves redirecting peripheral nerves in a patient’s arms and hands by connecting healthy nerves to the injured nerves. The new nerve network revives communication between the brain and the muscles allowing patients to once again undertake independent tasks such as feeding themselves or writing with a pen. Nine quadriplegic patients with spinal cord injuries in the neck underwent nerve-transfer surgery and each of them 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,” says Ida K. Fox, MD, assistant professor of plastic and reconstructive surgery and lead author of the study.

Hope for Full Movement

Medical professionals hope to eventually discover a way to restore full movement. There are some 250,000 people in the United States with spinal cord injuries and over half of such injuries involve the neck.  But until a cure is found, progress in restoring basic independence for routine tasks is important. “Our innovations to address spinal cord injuries came directly from a quarter century of nerve-transfer work in nerve injury,” says Susan E. Mackinnon, MD, director of the Division of Plastic and Reconstructive Surgery at the School of Medicine. “We want to continue building our expertise in this area very carefully. While the surgery itself can be relatively straightforward, the decision-making is complicated. We want to encourage people with spinal cord injury to consider this option when so little is often offered or made available.”


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