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Updated: Sep 3, 2025
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Structured Motor Rehabilitation After Selective Nerve Transfers
Published on: August 15, 2019
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Spontaneous Motor Recovery after Cervical Spinal Cord Injury: Issues for Nerve Transfer Surgery Decision Making.
Jana Dengler1,2, John D Steeves3, Armin Curt4
1Division of Plastic and Reconstructive Surgery, Tory Trauma Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
Spinal Cord
|July 27, 2022
Summary
Spinal cord injury (SCI) patients show limited spontaneous upper extremity motor recovery between 6 and 12 months. Early surgical consultation at 6 months post-injury is recommended for better decision-making regarding nerve transfer surgery.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Orthopedic Surgery
Background:
- Spinal cord injury (SCI) significantly impairs upper extremity motor function.
- Understanding spontaneous recovery patterns is crucial for optimizing treatment strategies, including nerve transfer surgery.
Purpose of the Study:
- To quantify spontaneous upper extremity motor recovery from 6 to 12 months post-SCI.
- To inform the timing of nerve transfer surgery for improved upper limb function in cervical SCI.
Main Methods:
- Retrospective cohort study utilizing data from the European Multicenter Study of SCI database.
- Analysis of muscle function grades (elbow extension, finger flexion) at 6 and 12 months post-injury in 268 individuals with mid-level cervical SCI.
Main Results:
- Limited surgically-relevant spontaneous recovery was observed between 6 and 12 months post-SCI.
- Only 4% of limbs with initial elbow extension grade 0-2 regained grade 4-5 function; 11% regained grade 3.
- 3% of limbs with initial finger flexion grade 0-2 regained grade 4-5; 5% regained grade 3.
Conclusions:
- Spontaneous motor recovery for surgically relevant function is minimal in the 6-12 month period after cervical SCI.
- Supports early surgical consultation (around 6 months post-injury) for informed patient decision-making.
- Facilitates shared decision-making regarding surgical intervention versus continued rehabilitation for functional recovery.
