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Upper Extremity Surgery in Cervical Spinal Cord Injury: A Prospective Comparative Mixed-Methods Study.

Rachel Skladman1, Caitlin A Francoisse2, Allison J L'Hotta3

  • 1From the Division of Plastic and Reconstructive Surgery.

Plastic and Reconstructive Surgery
|February 12, 2024
PubMed
Summary
This summary is machine-generated.

Tendon transfer (TT) and nerve transfer (NT) surgery significantly improve upper extremity function in cervical spinal cord injury (SCI) patients compared to no surgery. These surgical interventions enhance daily living activities and independence.

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Area of Science:

  • Neurosurgery
  • Rehabilitation Medicine
  • Spinal Cord Injury Research

Background:

  • Cervical spinal cord injury (SCI) severely impacts patient independence and quality of life.
  • Restoration of upper extremity function is a primary goal for SCI patients.
  • Tendon transfer (TT) and nerve transfer (NT) are surgical options for functional restoration.

Purpose of the Study:

  • To prospectively compare long-term upper extremity functional changes in cervical SCI patients.
  • To evaluate outcomes between surgical (TT or NT) and nonsurgical management.
  • To utilize a mixed-methods approach for comprehensive assessment.

Main Methods:

  • A multicenter cohort study design comparing three groups: no surgery, TT surgery, and NT surgery.
  • Quantitative data collected using the Spinal Cord Independence Measure (SCIM) and SF-36 Health Survey at baseline and 6-24 months.
  • Qualitative data from semistructured interviews with participants and caregivers at multiple time points.

Main Results:

  • SCIM scores demonstrated significant improvement in both TT and NT groups versus the no-surgery group (P < 0.05).
  • No significant differences were observed in SF-36 scores among the groups.
  • Qualitative data confirmed functional gains in activities of daily living, transfers, and specialized tasks like operating electronics or a motor vehicle.

Conclusions:

  • TT and NT surgeries result in significant quantitative and qualitative functional improvements for cervical SCI patients.
  • Postoperative therapy is crucial for maximizing functional gains.
  • This comparative data can aid surgeons in discussing treatment options with patients.