Groundbreaking Surgery allows 13 paralysis patients to regain the use of their arms



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Groundbreaking nerve surgery has 13 patients paralyzed in their crashes and sporting accidents to use their arms again.

Doctors in Australia have successfully reconnected patients with grafting healthy nerves in the place of damaged ones.

Faced with a lifetime of tetraplegia leaving them unable to move their arms or legs, the patients can now feed themselves, write and even use their phones.

Scientists have released fascinating video footage of patients opening their hands and using their arms.

Although the procedure has not been perfected and is not routinely used.

The repeated success of the surgery in this study, however, is hailed as an 'exciting' breakthrough in what could revolutionize life after devastating spinal cord injuries.

Nerve transfer surgery works by removing a healthy nerve from elsewhere in the body and using it to reconnect a paralyzed muscle to the brain by surgically grafting it on

Nerve transfer surgery works by removing a healthy nerve from elsewhere in the body and using it to reconnect a paralyzed muscle to the brain by surgically grafting it on

One of the men involved in the study features in a fascinating video that shows him to be able to pick up a bottle with one hand and grip it with the other, after being completely paralyzed in an accident around three years ago

One of the men involved in the study features in a fascinating video that shows him to be able to pick up a bottle with one hand and grip it with the other, after being completely paralyzed in an accident around three years ago

Doctors at Austin Health in Melbourne published a paper outlining the cases of nerve transfer procedures.

The people were 27 years old, on average, and were paralyzed by spinal injuries in accidents on the road, while playing sport, while diving or from falls.

None were able to test their grasp and pinch strength before surgery, meaning they were unable to use their hands.

But, just two years after the life-changing operation, 13 of the patients had enough movement and control in their limbs to successfully carry out the tests.

Two participants did not stick with the research for the full two years and one died of causes unrelated to the study, the journalist revealed in the medical journal The Lancet.

Thanks to the operations and two years of rehab, patients could pick up small objects, brush their teeth and hair, put on make-up, handle money and credit cards and even use tools.

Surgeons managed to restore their muscle function by grafting healthy nerves from above the spinal cord.

These nerves were taken from the researchers as 'spare', and would not grow back in their original location.

The leading study, reconstructive surgeon Dr. Natasha van Zyl, said: 'For people with tetraplegia, improvement in hand function is the single most important goal.

This unnamed patient had both nerve and tendon transfers. His left hand, he said, was better and better for heavy motor skills. If given the choice, he said, he would have one of each again

This unnamed patient had both nerve and tendon transfers. His left hand, he said, was better and better for heavy motor skills. If given the choice, he said, he would have one of each again

'We believe nerve transfer surgery offers an exciting new option, offering patients with paralysis the possibility of regaining arm and hand functions.

'[This would allow them] to perform everyday tasks and give them greater independence and the ability to participate more easily in family and work life. '

When they are affected by injury or disease, they lose their ability to transmit signals to the brain.

In serious injuries – which will never grow back, leading to muscles being paralyzed forever.

HOW DOES NERVE TRANSFER SURGERY WORK?

Nerve transplant surgery by replacing nerves damaged in an injury with healthy ones from elsewhere in the body.

When someone is injured in a way that disturbs, damages or completely breaks their nerves, they may lose the ability to control parts of the body, leading to paralysis.

This is because of the nerves, of which there are around 100billion in the body, act like electric wires carrying signals from the brain to the body.

When these are blocked the muscles are paralyzed and the skin may lose its feeling.

In nerve transfer surgery, working nerves taken from areas unaffected by the injury – above the damage to the spinal cord in a spinal injury, for example – are removed intact and grafted elsewhere in the body.

The healthy nerves are then reconnected to a functioning part of the spinal cord and to the paralyzed muscle, essentially making a bypass around the damaged nerve.

This means signals to and from the brain can go back to life.

After surgery it can take months to grow to muscle – they tend to grow to a maximum of 2mm to 5mm per day – and even more to strength.

Surgery should be done within six to 12 months of injury because the patient is more likely to have their muscles weakened and left behind.

The spinal cord – a thick bundle of nerves running through the bony spinal column – is the root of all the body's nerves, which is what makes spinal injuries so traumatic.

The researchers say there are up to 500,000 spinal cord injuries per year around the world, with more than half resulting in tetraplegia – neck-down paralysis.

Each of the Melbourne patients had their surgery within 18 months of their original injury. Longer waits leave more time for muscles to weaken and waste away.

In 10 of the people, both surgeries and tendon transfers, and nerve grafts.

The research was able to restore fine motor skills, allow patients to grasp and pick things up.

While tendon transfers, which involved moving a muscle and tendon to the site of a paralyzed one, they were better for bringing back strength for facelift.

Dr. van Zyl and his team said nerve transfers were 'attractive' because they could revive the correct muscles and more.

Tendon grafts, in contrast, could only replace muscles on a one-for-one basis and the limb would have to adapt to a muscle developed elsewhere in the body.

One unnamed patient who had both surgeries was filmed using his newly acquired arms, and then he did it again.

Speaking to a doctor, he said: 'My left hand is a lot more for picking up things and the end of movements.

Like, I'll pick up something with my left, which I would not be able to do with my right, but then I can get it in my right hand . '

When asked which one he preferred he said he would choose to have the mix again so he could use his arms for different tasks.

Dr. Mark Dallas, a neuroscientist at the University of Reading, was not involved in this research.

"Rewiring of the nervous system to restore power and feeling after a spinal cord injury can have a huge impact in improving quality of life," he said.

'This current study … highlights that the restorative improvements are long lasting and lead to a greater level of independence for these individuals.

'[But] it should be noted that this intervention does not restore function to a pre-injury state.

A video shows a woman who has the ability to open and clench her fist after surgery

Even when nerve function is restored and muscles come back to life

A video shows a woman who has had a great deal of experience with her surgery, despite having been paralyzed just years earlier

The patients in the videos had two years of physiotherapy after their operations to rebuild their muscles, which quickly became weaker when not used.

And even promising, the nerve transfer surgery is not perfect.

The cause is revealed to be a cause of loss of sensation or weakness.

It's also a slow process and it may take months for muscle regrowth – they tend to grow at a maximum of 2mm to 5mm per day – and then increase muscle strength.

Professor Tara Spires-Jones, Deputy Director of the Center for Discovery Brain Sciences at the University of Edinburgh said the study was 'important'.

One patient, whose name is unknown, is seen using his trained-paralysed right arm to reach up, grab a water bottle and make a controlled drinking motion

One patient, whose name is unknown, is seen using his trained-paralysed right arm to reach up, grab a water bottle and make a controlled drinking motion

But she added: 'It is important to keep in mind that this was still a relatively small study.

'The improvement in function will make a difference for people with tetraplegia but it is not a complete cure for this type of paralysis as complete, normal function is not restored.'

The researchers said their study was the first to analyze the effects of multiple attempts at the same combinations of surgery.

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