Principal Investigator: Mark Mahan
Keywords: nerve transfers , spinal cord injury Department: Neurosurgery - Adult
IRB Number: 00126462
Specialty: Neurosurgery
Sub Specialties: Neurovascular Surgery
Recruitment Status: Not yet recruiting

Contact Information

Andrea Strauss
ANDREA.STRAUSS@HSC.UTAH.EDU
801-587-2924

Brief Summary

The rationale for this research is establishing pilot data for treating spinal cord injury patients with nerve transfers, will provide guidance for both clinical management and will prove useful in generating treatment algorithms incorporating nerve and tendon transfer strategies. We also expect these findings will serve as a useful tool in counseling families and in patient selection for future SCI clinical trials.

Specific Aim:

1) Measure the efficacy of nerve transfer surgery in the treatment of patients with complete cervical spinal cord injuries with no hand function.

Detailed Description

The rationale for this research is establishing pilot data for treating spinal cord injury patients with nerve transfers, will provide guidance for both clinical management and will prove useful in generating treatment algorithms incorporating nerve and tendon transfer strategies. We also expect these findings will serve as a useful tool in counseling families and in patient selection for future SCI clinical trials.Specific Aim:1) Measure the efficacy of nerve transfer surgery in the treatment of patients with complete cervical spinal cord injuries with no hand function.

Inclusion Criteria

1. Age 18-65, inclusive
2. At least 3 months of non-operative rehab therapy
3. Mentally and physically willing and able to comply with evaluations
4. Less than 36 months post-cervical spinal cord injury with diagnosis of tetraplegia
5. Stable ASIA scores with no evidence of functional improvement in motor or sensory examination for at least 3 months
6. ASIA A or B determined by the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI)
7. EMG/NCS verifies intact innervation (normal CMAPs) to the paralyzed target muscles below the level of injury 8. Functional electrical stimulation (FES) will be performed. Subject must have clinically normal MRC grade 5/5 donor (axonal) function

8.SCI level C4-C8

Exclusion Criteria

1. Active infection at the operative site or systemic infection
2. Any return or ongoing clinical recovery of distal motor function
3. Mentally or physically compromised that will prevent them from complying with evaluations.
4. Immunologically suppressed
5. Currently undergoing long-term steroid therapy
6. Current active malignancy
7. Pregnant
8. Significant joint contractures and/or limitations in passive range of motion in the arm or hand, per treating surgeon’s discretion
9. Lack of appropriate social support and/or infrastructure to commit to scheduled follow-up visits.

10. Patients who have had a tendon transfer or who are planning on undergoing a tendon transfer during the study period.

11. Patients who could be designated as part of a vulnerable population such as pregnant women, prisoners, mentally disabled patients, patients with cognitive impairments, wards of the state, or students, staff, or faculty of the institution.