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Improving Hand Function after Cervical Spinal Injury
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Author:  Badri [ 19 Oct 2015 00:12 ]
Post subject:  Improving Hand Function after Cervical Spinal Injury

A few weeks ago there was a report in the Times Newspaper that nine patients paralysed from the neck down regained movement in their hands and arms thanks to a pioneering operation. Most of us don't think twice before picking up a pen, or the phone, or reaching for a fork, but loss of hand function is one of more devastating consequences of spinal cord injury.
A void remains in treatment options that produce a reliable and robust improvement in patient function. After surgical stabilization of the spinal column and recovery from the acute component of injury, many patients are left with permanent motor dysfunction.

Cervical level spinal cord injury can significantly affect hand function. Depending on the level and type of injury, surgery to improve hand and arm function may be an option. Surgical treatment may include nerve transfers or other procedures. The surgical procedure was reported recently from the Dept of Neurosurgery, Washington University. The procedure bypasses the damaged spinal cord and re-routes nerves from above the level of injury to a nerve in the arm that arises from the cord below the level of injury. This nerve which would otherwise be useless can now make the muscle it innervates to contract.

This nerve transfer surgery can only benefit patients with specific types of spinal cord injury. To be eligible, a patient must have quadriplegia with a motor level C6 or C7 spinal cord injury. Because the procedure relies on working nerves above the C6 and C7 level, it will not benefit patients with cervical spinal cord injuries at a higher level. The primary aim of the procedure is to restore hand function with the ability to pinch the thumb and index finger.

The quadriplegics have been able to feed themselves and even write with a pen. Surgeons said that regaining even some small movement “restores a significant amount of dignity”. As part of a comprehensive program to treat patients with acute and chronic spinal cord injuries, Neurosurgeons at Washington University offer nerve transfer procedures to provide improved upper extremity and hand function tailored to each patient’s level of initial injury and preserved motor and sensory function.

Michael Bavlsik, Asst.Professor of Primary care became quadriplegic after an accident. Following nerve transfer surgery he was able to feed himself with a fork, write with a pen and drive his children to their activities. One patient who was totally dependent on carers to catheterise him was able to do that himself after the operation.

Part of the information was provided by The Dept of Neurosurgery Washington University.

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