title: Review of Upper Extremity Nerve Transfer in Cervical Spinal Cord Injury.
abstract: OBJECTIVE
  Several nerve transfers have now been successfully performed for upper limb reanimation in tetraplegia. This study was performed to review the use of nerve transfers for upper limb reanimation in tetraplegia.
  
  
  METHODS
  Medline and Embase (1950 to February 11, 2015) were searched using a search strategy designed to include any studies that reported cases of nerve transfer in persons with cervical spinal cord injury (SCI).
  
  
  RESULTS
  A total of 103 manuscripts were selected initially and full-text analysis produced 13 studies with extractable data. Of these manuscripts, 10 reported single cases and 3 reported case series. Eighty-nine nerve transfers have been performed in 57 males and 2 females with a mean age of 34 years. The mean SCI level was C6 (range: C5-7), time to surgery post-SCI was 19.9 months (range: 4.1-156 months), and follow-up time was 18.2 months (range: 3-60 months). All case reports recorded a Medical Research Council (MRC) score of 3 or 4 for recipient muscle power, but two early case series reported more variable results.
  
  
  CONCLUSIONS
  This review documents the current status of nerve transfer surgery for upper limb reanimation in tetraplegia and summarizes the functional results in 59 cases with 89 nerve transfers performed, including 15 cases of double-nerve transfer and 1 case of triple-nerve transfer.
authors.affiliation: Department of Plastic and Reconstructive Surgery, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Cain
authors.affiliation: Tetraplegia Hand Surgery, Swiss Paraplegia Centre, Nottwil, Switzerland; Department of Plastic, Reconstructive and Aesthetic Surgery, Hand Surgery, University Hospital, Basel, Switzerland.
authors.forename: Andreas
authors.initials: A
authors.lastname: Gohritz
authors.affiliation: Tetraplegia Hand Surgery, Swiss Paraplegia Centre, Nottwil, Switzerland; Center of Advanced Reconstruction of Extremities (CARE), National Reference Center for Tetraplegia Surgery, Sahlgrenska University Hospital, Göteborg, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Fridén
authors.affiliation: Department of Plastic and Reconstructive Surgery, The Royal Melbourne Hospital, Parkville, Victoria, Australia; Victorian Spinal Cord Service, Austin Health, Heidelberg, Victoria, Australia; Department of Medicine, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Natasha
authors.initials: N
authors.lastname: van Zyl
keywords: nerve transfer; quadriplegia; spinal cord injury; tetraplegia