A new surgical procedure developed by Australian scientists and surgeons has given hope to people with quadriplegia. According to a case study published in The Lancet, 13 out of 16 patients who underwent nerve transfer surgery were able to use their hands again. The patients were young adults with an average age of 27, whose quadriplegia was caused by an accident less than 1.5 years before the operation. The new procedure involves connecting functioning nerve pathways with the deactivated muscles in the arm and hand of patients with tetraplegia. The surgeons use nerves above the spinal cord injury that are still connected to the brain. The functioning nerve pathways are detached from their original target muscle and surgically reconnected to the muscle that needs to be activated.
After the operation, the healthy nerve grows about one millimeter per day along the non-functioning nerve pathway until it reaches the target muscle. The growth phase lasts between three and nine months, depending on the muscle and nerve. Once the nerve reaches the target muscle, patients can move their hands again. The new procedure gives quadriplegics greater independence and the ability to participate more easily in family and work life. Patients can eat, use a computer, or apply makeup on their own. They can also use their elbows to move their wheelchair. The new operation is less invasive than the traditional method of using tendons from active muscles and connecting them to paralyzed muscles. Patients only need to wear a sling for ten days instead of an orthosis for six to twelve weeks.
The scientists compared the results of the nerve transfer surgery with those of the tendon transfer surgery. They found that the tendon transfer surgery resulted in a stronger grip, while the nerve transfer surgery allowed for finer hand movements. The choice of treatment depends on the patient’s main tasks after the operation. Unfortunately, the nerve transfer surgery did not produce the desired results for three of the 16 patients. The scientists plan to conduct further studies to determine which patients are suitable for the new procedure. They also emphasized that nerve transfer surgery is only effective if performed within a year of the accident that caused the paralysis.
