Factors That Influence the Clinical Outcome After Tendon Transfer Surgery to Restore Grip Function in Individuals With Tetraplegia.

Abstract

Background: Approximately 50% of spinal cord injuries (SCI) occur at the cervical level, resulting in significant loss of arm and hand function. Restoration of upper limb function is a high priority, and many opt for upper limb reconstructive surgeries to improve daily activities and psychological well-being.

Objectives: This retrospective multicenter study investigates whether demographic data (sex and age) and clinical characteristics (type of SCI and years since injury) are related to the outcome of upper limb reconstructive surgery.

Methods: Data were extracted from medical records of individuals with an SCI who underwent surgery in Sweden and New Zealand. Muscle strength (pinch, grip) and grasp ability were measured before surgery and at 6 or 12 months after surgery using standard methods. Statistical analyses included univariable and multivariable linear regression to assess the association between outcomes and predictors. Outcomes were available for 183 arms at follow-up, assessed through at least one of the response variables: grip strength, pinch strength, or grasp ability.

Results: The analyses demonstrated that by using regression models, we could explain 24% to 31% of the variation in pinch strength, grip strength, and grasp ability. The variables of sex, age, and level and severity of injury did explain a small but statistically significant proportion of the variance in pinch strength, grip strength, and grasp ability. Years after injury had no influence on the variation in outcome scores.

Conclusion: The findings suggest that demographic and injury-related factors partially explain the variation in functional outcomes after surgery, providing valuable insights for clinical decision-making and managing patient expectations.