Rachel Skladman, Caitlin A Francoisse, Allison J L'Hotta, Christine B Novak, Catherine M Curtin, Doug Ota, Katherine C Stenson, Katharine Tam, Carie R Kennedy, Aimee James, Ida K Fox
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引用次数: 0
Abstract
Background: Cervical spinal cord injury (SCI) has a devastating effect on health and independence. Restoring upper extremity function is a top priority and can be accomplished by tendon transfer (TT) and nerve transfer (NT) surgery. The purpose of this prospective comparative study was to assess long-term changes in upper extremity function between surgical (TT or NT) and nonsurgical groups through a comprehensive mixed-methods approach.
Methods: This multicenter cohort study compared data among 3 groups: those undergoing no surgery, TT surgery, or NT surgery. Quantitative data from the Spinal Cord Independence Measure (SCIM) and 36-item Short Form Health Survey were collected at baseline and long-term follow-up (6 to 24 months). Qualitative semistructured interview data were also obtained from these participants and their identified caregivers at baseline, early follow-up (1 month), and long-term follow-up (6 to 24 months).
Results: Thirty-one participants had quantitative data across all time points: no surgery ( n = 14), TT ( n = 7), and NT ( n = 10). SCIM scores improved in TT and NT groups compared with the no-surgery group ( P < 0.05). The 36-Item Short Form Health Survey scores did not differ among groups. Qualitative data analysis ( n = 168 interviews) corroborated SCIM findings: surgical participants and their caregivers reported improvement in transfers and ability to perform activities of daily living, including grooming and self-catheterization. Improved use of electronics and ability to operate a motor vehicle were also reported. Postoperative therapy was identified as a critical component of achieving gains.
Conclusions: TT and NT surgery lead to quantitative and qualitative functional gains when compared to no surgery. This comparative information should be used to help surgeons discuss treatment options.
Clinical qusetion/level of evidence: Therapeutic, II.
期刊介绍：
For more than 70 years Plastic and Reconstructive Surgery® has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. Plastic and Reconstructive Surgery® , the official journal of the American Society of Plastic Surgeons, is a benefit of Society membership, and is also available on a subscription basis.
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