Nerve Transfers for Tetraplegia

Abstract

Cervical spinal cord injury can result in loss of upper extremity function including elbow extension, hand opening and closing. Together, these losses can severely limit independence, negatively impact quality of life, and the ability to perform activities of daily living without assistance from family or caregivers. Thus, restoration of hand and upper extremity function is critical and often a top priority for patients with tetraplegia. While reconstructive surgical techniques such as tendon transfer, tenodesis and arthrodesis have been long used to accomplish this, nerve transfers have recently demonstrated excellent outcomes and are now being incorporated into treatment algorithms for these patients either alone or in conjunction with tendon transfer. Here, we review the pathophysiology of spinal cord injury, commonly performed nerve transfers, complications and expected outcomes.