TY - JOUR
T1 - Comparing surgeries to restore upper extremity function in tetraplegia
T2 - Impact on function during the perioperative period
AU - Francoisse, Caitlin A.
AU - Peters, Blair R.
AU - Curtin, Catherine M.
AU - Novak, Christine B.
AU - Russo, Stephanie A.
AU - Tam, Katharine
AU - Ota, Doug T.
AU - Stenson, Katherine C.
AU - Steeves, John D.
AU - Kennedy, Carie R.
AU - Fox, Ida K.
N1 - Publisher Copyright:
© The Academy of Spinal Cord Injury Professionals, Inc. 2024.
PY - 2024
Y1 - 2024
N2 - Context/Objective: To assess short-term changes in health outcomes in people with cervical-level spinal cord injury (SCI) who underwent upper extremity (UE) reconstruction via either novel nerve transfer (NT) or traditional tendon transfer (TT) surgery with individuals who did not undergo UE surgical reconstruction. Design: Prospective, comparative cohort pilot study. Participants: 34 participants with cervical SCI met the following inclusion criteria: age 18 or older, greater than 6 months post-injury, and mid-cervical level SCI American Spinal Injury Association Impairment Scale (AIS) A, B or C. Setting: Two tertiary academic hospitals and their affiliated veterans’ hospitals. Methods: Health outcomes were assessed using two previously validated measures, the Spinal Cord Independence Measure (SCIM) and Short-Form Health Survey (SF-36). Demographic, surgical, and survey data were collected at the initial evaluation and one month postoperatively/post-baseline. Results: 34 participants with cervical SCI were recruited across three cohorts: no surgery (n = 16), NT (n = 10), and TT (n = 8). The TT group had a decline in SCIM and SF-36 scores whereas the NT and no surgery groups experienced little change in independence or health status in the immediate perioperative period. Conclusions: Surgeons and rehabilitation providers must recognize differences in the perioperative needs of people with cervical SCI who chose to have restorative UE surgery. Future work should focus on further investigation of health outcomes, change in function, and improving preoperative counseling and cross-disciplinary management.
AB - Context/Objective: To assess short-term changes in health outcomes in people with cervical-level spinal cord injury (SCI) who underwent upper extremity (UE) reconstruction via either novel nerve transfer (NT) or traditional tendon transfer (TT) surgery with individuals who did not undergo UE surgical reconstruction. Design: Prospective, comparative cohort pilot study. Participants: 34 participants with cervical SCI met the following inclusion criteria: age 18 or older, greater than 6 months post-injury, and mid-cervical level SCI American Spinal Injury Association Impairment Scale (AIS) A, B or C. Setting: Two tertiary academic hospitals and their affiliated veterans’ hospitals. Methods: Health outcomes were assessed using two previously validated measures, the Spinal Cord Independence Measure (SCIM) and Short-Form Health Survey (SF-36). Demographic, surgical, and survey data were collected at the initial evaluation and one month postoperatively/post-baseline. Results: 34 participants with cervical SCI were recruited across three cohorts: no surgery (n = 16), NT (n = 10), and TT (n = 8). The TT group had a decline in SCIM and SF-36 scores whereas the NT and no surgery groups experienced little change in independence or health status in the immediate perioperative period. Conclusions: Surgeons and rehabilitation providers must recognize differences in the perioperative needs of people with cervical SCI who chose to have restorative UE surgery. Future work should focus on further investigation of health outcomes, change in function, and improving preoperative counseling and cross-disciplinary management.
KW - Cervical spinal cord injury
KW - Health outcomes
KW - Nerve transfer surgery
KW - Perioperative rehabilitation
KW - Tendon transfer surgery
KW - Tetraplegia
KW - Upper extremity reconstruction
UR - http://www.scopus.com/inward/record.url?scp=85182457663&partnerID=8YFLogxK
U2 - 10.1080/10790268.2023.2283238
DO - 10.1080/10790268.2023.2283238
M3 - Article
C2 - 38232181
AN - SCOPUS:85182457663
SN - 1079-0268
JO - Journal of Spinal Cord Medicine
JF - Journal of Spinal Cord Medicine
ER -