Sarah A Cain1, Andreas Gohritz2, Jan Fridén3, Natasha van Zyl4. 1. Department of Plastic and Reconstructive Surgery, The Royal Melbourne Hospital, Parkville, Victoria, Australia. 2. Tetraplegia Hand Surgery, Swiss Paraplegia Centre, Nottwil, Switzerland; Department of Plastic, Reconstructive and Aesthetic Surgery, Hand Surgery, University Hospital, Basel, Switzerland. 3. Tetraplegia Hand Surgery, Swiss Paraplegia Centre, Nottwil, Switzerland; Center of Advanced Reconstruction of Extremities (CARE), National Reference Center for Tetraplegia Surgery, Sahlgrenska University Hospital, Göteborg, Sweden. 4. Department of Plastic and Reconstructive Surgery, The Royal Melbourne Hospital, Parkville, Victoria, Australia; Victorian Spinal Cord Service, Austin Health, Heidelberg, Victoria, Australia; Department of Medicine, University of Melbourne, Parkville, Victoria, Australia.
Abstract
OBJECTIVE: Several nerve transfers have now been successfully performed for upper limb reanimation in tetraplegia. This study was performed to review the use of nerve transfers for upper limb reanimation in tetraplegia. METHODS: Medline and Embase (1950 to February 11, 2015) were searched using a search strategy designed to include any studies that reported cases of nerve transfer in persons with cervical spinal cord injury (SCI). RESULTS: A total of 103 manuscripts were selected initially and full-text analysis produced 13 studies with extractable data. Of these manuscripts, 10 reported single cases and 3 reported case series. Eighty-nine nerve transfers have been performed in 57 males and 2 females with a mean age of 34 years. The mean SCI level was C6 (range: C5-7), time to surgery post-SCI was 19.9 months (range: 4.1-156 months), and follow-up time was 18.2 months (range: 3-60 months). All case reports recorded a Medical Research Council (MRC) score of 3 or 4 for recipient muscle power, but two early case series reported more variable results. CONCLUSION: This review documents the current status of nerve transfer surgery for upper limb reanimation in tetraplegia and summarizes the functional results in 59 cases with 89 nerve transfers performed, including 15 cases of double-nerve transfer and 1 case of triple-nerve transfer.
OBJECTIVE: Several nerve transfers have now been successfully performed for upper limb reanimation in tetraplegia. This study was performed to review the use of nerve transfers for upper limb reanimation in tetraplegia. METHODS: Medline and Embase (1950 to February 11, 2015) were searched using a search strategy designed to include any studies that reported cases of nerve transfer in persons with cervical spinal cord injury (SCI). RESULTS: A total of 103 manuscripts were selected initially and full-text analysis produced 13 studies with extractable data. Of these manuscripts, 10 reported single cases and 3 reported case series. Eighty-nine nerve transfers have been performed in 57 males and 2 females with a mean age of 34 years. The mean SCI level was C6 (range: C5-7), time to surgery post-SCI was 19.9 months (range: 4.1-156 months), and follow-up time was 18.2 months (range: 3-60 months). All case reports recorded a Medical Research Council (MRC) score of 3 or 4 for recipient muscle power, but two early case series reported more variable results. CONCLUSION: This review documents the current status of nerve transfer surgery for upper limb reanimation in tetraplegia and summarizes the functional results in 59 cases with 89 nerve transfers performed, including 15 cases of double-nerve transfer and 1 case of triple-nerve transfer.
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