Surgeons at Austin Health in Melbourne used nerve transfers, rerouting working nerves above the injury to paralyzed muscles below it, in 16 people with early cervical spinal cord injuries across 27 limbs, adding tendon transfers in ten.
Two years after surgery, median scores on a standard test of arm and hand function nearly doubled, rising from 16.5 to 34.0, and a separate measure of grasp and release ability more than tripled, from 35.0 to 125.2, with triceps strength and finger extension both reaching functional grades. Six surgery-related adverse events occurred, none with lasting effects.
Combining nerve transfers with tendon transfers meant patients could regain more independent, separately controlled hand movements than tendon transfers alone typically provide, since a rerouted nerve can still carry some of the brain's original signal rather than yoking two muscles together permanently. The series was not randomized against tendon transfer alone, and timing the surgery early after injury, before muscles atrophy, appeared to matter for the result.
Read the original study
van Zyl et al., The Lancet, 2019 · doi.org/10.1016/S0140-6736(19)31143-2
A rerouted nerve, a hand that works again.
Source
- van Zyl, N., Hill, B., Cooper, C., Hahn, J., & Galea, M. P. (2019). Expanding traditional tendon-based techniques with nerve transfers for the restoration of upper limb function in tetraplegia: a prospective case series. The Lancet, 394(10198), 565–575. https://doi.org/10.1016/S0140-6736(19)31143-2