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Characterization of Spinal Cord Injury Patients for Arm Functional Restoration through Nerve Transfer
Andrew Jack1, Mithun Rajshekar2, Christopher D Witiw3
1Division of Neurosurgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada.
Summary
Nerve transfers (NT) may benefit many patients with traumatic spinal cord injuries (tSCI). This study identified epidemiological and injury characteristics of tSCI patients suitable for NT, aiding in treatment selection.
Area of Science:
- Neurosurgery
- Regenerative Medicine
- Epidemiology
Background:
- Traumatic spinal cord injuries (tSCI) frequently cause irreversible debilitation.
- Novel strategies like nerve transfers (NT) are crucial for mitigating secondary damage and enhancing function.
- Limited epidemiological data exists for tSCI patients eligible for NT.
Purpose of the Study:
- To characterize the epidemiological and injury-related aspects of tSCI patients.
- To identify the number and types of tSCI individuals who could benefit from NT.
- To inform patient selection for NT interventions.
Main Methods:
- Adults (<80 years) with cervical tSCI (C1-T1) admitted between 2005-2019 were evaluated.
- Suitability for NT was determined by two independent peripheral nerve experts based on specific neurological criteria (donor MRC ≥ 4/5, recipient ≤ 2/5).
- Demographic, traumatic, and neurological variables were collected and analyzed.
Main Results:
- Out of 709 tSCI patients, 224 (32%) met initial selection criteria.
- 108 patients (15% of all tSCIs, 48% of cervical tSCIs) were identified as appropriate NT candidates.
- Patient eligibility for NT fluctuated over time due to neurological recovery or changes.
Conclusions:
- A significant proportion of individuals with cervical tSCI are potential candidates for NT.
- This study provides the first detailed analysis of tSCI patient numbers qualifying for NT from a large prospective database.
- Findings can guide the application of NT for improved functional outcomes in tSCI patients.
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