Identification of patients with cervical SCI suitable for early nerve transfer to achieve hand opening.
METHODS
Retrospective audit.


OBJECTIVE
The objective of this study was to identify the proportion of patients with cervical spinal cord injury who would potentially benefit from nerve transfer surgery to gain active hand opening, and to determine when a safe nerve transfer decision can be made.


METHODS
Christchurch, New Zealand.


METHODS
Case note review of the first 12 months following acute cervical spinal cord injury (2007-2012). Neurological assessment at 6 weeks, 12 weeks and 1 year following injury.


RESULTS
Fifty-three patients had complete assessments and showed changes in the level of injury and severity of neurological injury between assessments. Forty-two percent of patients had motor complete C5-7 level injuries 12 weeks following injury and would benefit from consideration for nerve transfer to improve hand opening. Fewer (26%) would benefit 1 year following injury owing to a change in the neurological level of injury.


CONCLUSIONS
Twelve-week neurological assessment identifies patients who may benefit from nerve transfer surgery. This enables referral for comprehensive upper limb assessment and reassessment of motor function to determine suitability for surgical intervention. Nerve transfer within the window of opportunity provides active hand opening for patients following cervical spinal cord injury.
Department of Surgery, University of Otago, Christchurch, New Zealand.
J W
JW
Simcock
Department of Surgery, University of Otago, Christchurch, New Zealand.
J A
JA
Dunn
Department of Surgery, University of Otago, Christchurch, New Zealand.
N T
NT
Buckley
Department of Surgery, University of Otago, Christchurch, New Zealand.
K D
KD
Mohammed
Department of Surgery, University of Otago, Christchurch, New Zealand.
G P
GP
Beadel
Department of Surgery, University of Otago, Christchurch, New Zealand.
A G
AG
Rothwell
D000293:Adolescent; D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000293:injuries; D005260:Female; D006225:Hand / Q000294:innervation* / Q000502:physiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016067:Nerve Transfer / Q000379:methods*; D009520:New Zealand / Q000453:epidemiology; D020127:Recovery of Function / Q000502:physiology; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D055815:Young Adult
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