Ida FoxPosted: October 17, 2014
Nerve Transfers for Spinal Cord Injuries
This got popularized for people with peripheral nerve injuries, and for the last couple of years has been taking off for people with SCI. This video shows Justin Brown talking about that.
The deal with an SCI is that you’ve got an intact neuron below the injury site. Its cell body is in the cord, safe and sound, and its axon runs out to a muscle. This was being done for people who had working hands but no elbow flexion . . . different procedures depending on where you were and who was doing the surgery. Okay, history, history, history.
She gets to a guy with a spinal cord injury. He came to the nerve transfer clinic; he was a doctor. She did the surgery when he was about 4 years out. Showing a video in which this guy is able to use his fingers to feed himself. So she became involved in working with a team to bring this kind of surgery to other sci patients.
The idea is the same as what they’ve been doing with people who have shoulder injuries. She’s trying to get her patients into surgery at about 6 months post. This is NOT the same as tendon transfers. The create (on purpose) a peripheral nerve injury to create function below the injury level.
Picture an intact nerve from just above the injury level being split off so that part of it goes to its original target muscle in your arm and part of it gets rerouted to one of the muscles that is below the injury level. This works.
Again, here’s Justin Brown talking in 2012 about how this works. I wrote the whole thing up in the Working 2 Walk 2012 book, and if you’re a candidate for this kind of hand-function repair, I recommend checking this out, either with Justin or with this woman, who’s at Washington University.