Quantifying Donor Deficits Following Nerve Transfer Surgery in Tetraplegia

Francoisse, Caitlin A.; Russo, Stephanie A.; Skladman, Rachel; Kahn, Lorna C.; Kennedy, Carie R.; Stenson, Katherine C.; Novak, Christine B.; Fox, Ida K.

doi:10.1016/j.jhsa.2022.08.014

Cited by 2 publications

(2 citation statements)

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“…Although the donor muscle is denervated, donors are chosen so that other backup muscles are available to maintain reasonable strength of the donor function, and generally the use of donor nerves has little impact on patients undergoing transfers. 17 Common nerve transfers in spinal cord injury patients include the following: • Patients with cervical myelopathy should be evaluated around 6 months from injury if they have less than antigravity elbow extension, finger flexion or extension, or wrist extension for the option of nerve transfer and to determine whether there is lower motor neuron injury, and thus, a time window for transfer.…”

Section: Commentmentioning

confidence: 99%

“…Ideally, axons from the transected terminal will grow into the perineural sheath of the recipient nerve and reinnervate muscle, thus improving, albeit not normalizing, muscle function. Although the donor muscle is denervated, donors are chosen so that other backup muscles are available to maintain reasonable strength of the donor function, and generally the use of donor nerves has little impact on patients undergoing transfers 17 . Common nerve transfers in spinal cord injury patients include the following:…”

Section: Weaknessmentioning

confidence: 99%

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Symptomatic Treatment of Myelopathy

Chuang

2024

CONTINUUM: Lifelong Learning in Neurology

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Objective This article discusses the effects of myelopathy on multiple organ systems and reviews the treatment and management of some of these effects. Latest Developments Recent advances in functional electrical stimulation, epidural spinal cord stimulation, robotics, and surgical techniques such as nerve transfer show promise in improving function in patients with myelopathy. Ongoing research in stem cell therapy and neurotherapeutic drugs may provide further therapeutic avenues in the future. Essential Points Treatment for symptoms of spinal cord injury should be targeted toward patient goals. If nerve transfer for upper extremity function is considered, the patient should be evaluated at around 6 months from injury to assess for lower motor neuron involvement and possible time limitations of surgery. A patient with injury at or above the T6 level is at risk for autonomic dysreflexia, a life-threatening condition that presents with elevated blood pressure and can lead to emergent hypertensive crisis. Baclofen withdrawal due to baclofen pump failure or programming errors may also be life-threatening. Proper management of symptoms may help avoid complications such as autonomic dysreflexia, renal failure, heterotopic ossification, and fractures.

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Section: Commentmentioning

confidence: 99%

Section: Weaknessmentioning

confidence: 99%