NERVE TRANSFERS FOR SPINAL CORD INJURY
As part of a comprehensive program to treat patients with acute and chronic spinal cord injuries, Dr. Mark Mahan, a neurosurgeon at the University of Utah, offers nerve transfer procedures to provide improved upper extremity and hand function to patients.
These nerve transfer procedures involve taking a working nerve connected to the spinal cord above the level of the patient’s injury (for example, see Musculocutaneous N. in the figure) and rerouting, or “transferring,” a portion of that nerve to restore movement and function to a nerve that is not working well. This is done by attaching a branch of it to a nerve in the arm or hand below the level of the patient’s injury (see Median N. in the figure).
This transfer allows a return to the function of muscles controlled by that nerve without reducing the strength of the patient’s other muscles. Every procedure is personalized to the individual patient’s level of the initial injury and to his or her own preserved motor and sensory function.
More than 50% of spinal cord injuries occur in the cervical spine, causing tetraplegia, or paralysis in all four limbs, and resulting in some form of loss in a patient’s arm and/or hand function. People with tetraplegia, just as all people, are dependent on the use of their upper extremities for mobility and for their activities of daily living (including self-catheterization, writing, feeding, and other functions). Hand function is consistently rated as the function patients with tetraplegia most want to be restored, rated above bowel and bladder function, sexual function, standing, and pain control. Recovering even partial arm and hand function for a patient can have an enormous impact on that patient’s independence and quality of life.
Dr. Mahan sees patients with a history of a cervical spinal cord injury who are candidates for nerve transfer surgery and works with neurologists and physical therapists to develop an operative plan that is specific to each patient’s unique circumstances. Nerve transfer procedures can provide meaningful improvements in a patient’s quality of life and long-term functional independence! If you would like more information, please contact Dr. Mahan’s team at mahanresearch@hsc.utah.edu or (801) 585-9821.
Prior to your appointment with Dr. Mahan, medical records from your initial injury will need to be sent to Dr. Mahan’s office to be reviewed to determine the most appropriate testing for you. You will need to undergo special testing of the muscles and nerves in your arms and hands. This electromyogram (EMG) and nerve conduction studies (NCS) are crucial in Dr. Mahan’s evaluation to determine which of your nerves and muscles are suitable for reanimation and restoration of function.