Nerve Transfer Surgery to Restore Upper-limb Function After Cervical Spinal Cord Injury

Condition(s) studied

Investigational drug(s) / intervention(s)

Nerve transfer surgery: The intervention in this study, which follows our clinical approach, is the "double nerve transfer" to restore grasp function (i.e., hand opening and hand closing). Finger and thumb extension (hand opening) is restored via the supinator-posterior interosseous nerve (PIN) transfer. Finger and thumb flexion (hand closing) is restored via a nerve transfer to the anterior interosseous nerve (AIN). There are two donor nerve options available to restore function to the muscles supplied by the AIN: the nerve to the brachialis and the nerve to the extensor carpi radialis longus (ECRL) or extensor carpi radialis brevis (ECRB).

Study summary

The goal of this prospective, open-label cohort study is to assess functional outcomes in individuals with cervical spinal cord injury who have undergone nerve transfer surgery to restore upper limb function. The main questions it aims to answer are:

* Does nerve transfer improve hand function in individuals with cervical spinal cord injury?
* What factors are associated with functional improvement following nerve transfer? Researchers will compare functional outcomes at 24 months post-surgery to 1) baseline outcomes and 2) individuals with cervical spinal cord injury who did not undergo nerve transfer.

Participants who have received nerve transfer surgery as part of their regular medical care will complete functional hand tests, electrodiagnostic assessments, and questionnaires on independence and mood every 3 months for 24 months after surgery.

Eligibility

Primary outcome measure(s)

• GRASSP (within-participant) — Baseline then every 3 months for 2 years
  Change in Graded Redefined Assessment of Strength, Sensibility and Prehension (GRASSP) score from baseline to 24 months post-surgery. GRASSP is a validated upper limb functional measure and previously is used in SCI (Kalsi-Ryan et al. 2012) incorporates three domains vital to upper limb function: sensation, strength, and prehension.

Trial sites (4)

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