Surgery restores arm function in some paralyzed patients: study

Australian surgeons have successfully restored arm function in paralyzed patients, enabling them to feed themselves, use tools and manipulate electronic devices, according to findings from an innovative study released Friday.

Thirteen young adults who suffered spinal injuries rendering them quadriplegic have undergone several operations and underwent intense physiotherapy during the largest ever application of a technique called nerve transfer surgery.

A team of surgeons managed to attach individual nerves located above the area of ​​the spinal injury to the nerves below the traumatic site. The functioning nerves were then used to stimulate the paralyzed muscles located below the injured area.

Each nerve transfer took about two hours of laborious reconstruction and the team completed 59 in all.

Two years after the procedure, most of the test participants were able to extend their arms, open and close the palm of their hand and manipulate objects.

Although the technique of nerve transfer is performed sporadically, tendon reconstruction has traditionally been associated with most operations aimed at restoring upper limb function.

This involves rerunning the muscles that are still functioning but that are designed for another function on another site in order to do the work of the paralyzed muscles.

"Major advance"

"Nerve transfers have been around for a long time, but they were not really used before to treat a spinal injury," AFP Natasha van Zyl, a surgeon at Austin Health in Melbourne, told AFP.

Prior to surgery, none of the patients were able to perform grasping or pinching tests.

Two years after the operation, they achieved high enough results to perform most daily activities, including brushing their teeth and writing.

"The number one priority for patients with spine injuries, before walking, before sexual function, is the function of the hand," said van Zyl, lead author of the study published in The lancet.

"You give them their hand, they can start working more efficiently, take care of themselves independently, drive, live alone."

The team pointed out that their sample was small and that four nerve transfer procedures did not improve the function of the hand or arm.

The surgery had no effect on the trunk control of the patients and they remained in a wheelchair.

But the surgeons said the technique was a "major breakthrough" in efforts to give people some measure of autonomy and control after suffering a decisive injury.

"All people in the world who have a spinal injury and all the people who treat them have the message" It is possible to restore the function of the hand and the function of the elbow, "said van Zyl.

© 2019 AFP