Nerve surgery brings hope to quadriplegics

Nine patients paralysed from the neck down have regained movement in their hands and arms thanks to a pioneering operation.

The quadriplegics have been able to feed themselves and even write with a pen. Surgeons said that regaining even some small movement ‘‘restores a significant amount of dignity’’.

The procedure bypasses the spinal cord, but re-routes nerves sitting above the injury site to the lifeless hand or arm. Ultimately, the hope is to discover a way to restore full movement to people living with spinal-cord injuries. The operation can be performed even years after a spinal-cord injury. It usually takes four hours and most patients go home the next morning. Once the new connection is established, patients undergo physical therapy over six to 18 months to train the brain to recognise new nerve signals.

Ida Fox, who led the study at Washington University in St Louis, Missouri, said: ‘‘Physically, nerve-transfer surgery provides incremental improvements in hand and arm function. However, psychologically, these small steps are huge for a patient’s quality of life.

‘‘One of my patients told me he was able to pick up a noodle off his chest when he dropped it. Before the surgery, he couldn’t move his fingers. It meant a lot for him to clean off that noodle without anyone helping him.’’

Michael Bavlsik, a father of eight and assistant professor of primary care, was left a quadriplegic after a traffic accident. After the procedure, he has been able to feed himself with a fork, write with a pen, look into patients’ ears with an otoscope and drive his children to activities.

Professor Bavlsik said: ‘‘Nervetransfer surgery has been very successful in helping me because it restored triceps function and improvement in my grip. I am extremely grateful for this surgery.’’

Professor Fox said that people with spinal-cord injuries lost the ability to control bladder or bowel function, relying on help from carers. She said: ‘‘After this surgery, one of my patients was able to independently catheterise himself, which he hadn’t been able to do since his accident over a decade ago. This boost in privacy and per- sonal space restores a significant amount of dignity.’’

Susan Mackinnon, who first developed nerve transfer surgery 25 years ago, said: ‘‘Our innovations to address spinal-cord injuries came directly from a quarter century of nerve-transfer work in nerve injury. We want to continue building our expertise in this area very carefully. While the surgery itself can be relatively straightforward, the decisionmaking is complicated. We want to encourage people with spinal-cord injury to consider this option when so little is often offered or made available.’’