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Current Best Peripheral Nerve Transfers for Spinal Cord Injury
1From the Division of Plastic and Reconstructive Surgery, Washington University.
Plastic and Reconstructive Surgery
|December 28, 2018
Summary
This guide explains how to identify upper versus lower motor neuron injuries after spinal cord injury (SCI). It details diagnostic methods and surgical nerve transfer options to restore upper extremity function.
Area of Science:
- Neurosurgery
- Neurology
- Rehabilitation Medicine
Background:
- Spinal cord injury (SCI) frequently results in complex motor neuron syndromes.
- Accurate diagnosis is crucial for effective treatment and functional recovery.
Purpose of the Study:
- To outline methods for localizing and differentiating upper motor neuron (UMN) from lower motor neuron (LMN) injury patterns in SCI.
- To guide surgical planning for nerve transfers to restore function.
Main Methods:
- Detailed patient history and neurological examination.
- Diagnostic imaging (e.g., MRI) and electrodiagnostic studies (e.g., EMG, NCS).
- Assessment of time-sensitive LMN injury versus non-time-sensitive UMN injury.
Main Results:
- Nerve transfers can restore function in select SCI patients with LMN deficits.
- Timely diagnosis and surgical intervention improve outcomes for upper extremity function.
Conclusions:
- A systematic approach combining clinical and diagnostic tools is essential for managing SCI.
- Nerve transfers offer a viable surgical option for functional restoration in specific SCI populations.
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