5 replies to this topic

[Mustafa Ozmen]

Hi,I am from Turkey.I had an accident in summer of 2007,as a result my neck was broken.My level is C4.I can move my right arm,elbow well.There is spasticity at my left elbow and left wrist.
A few months ago I came accross the following webpage http://www.tetraplegia.info which gives info about Functionnal surgery and rehabilitation of upper limbs in tetraplegia.Does anyone know anything about that? In that webpage there is a hospital name, Service de Chirurgie Plastique. Hopital Saint-Louis. 75475 Paris Cedex 10. France,I tried to contact to them but nobody replied.
In June 2012 I will go to Berlin,does anyone know about any hospital in Germany doing that kind of surgeries?Please help...

[qbounce]

Sorry Mustafa for the non responsiveness to your post. It must have gotten overlooked during the holidays.
The only way I can see these types of surgeries benefiting someone is only if you've had a certain range of motion after your SCI, then subsequently, due to overuse, you've noticed a significant deterioration in said area. Take your elbow for example, we use it to wheel, transfer, and especially leaning on it can cause deterioration in the nerve root. I've heard of surgery helping THESE types of situations.
In the instance of surgically getting your hand function back after a cervical injury however, isn't any more possible than having leg surgery to walk again. It can't be done. Once your spinal cord was severed, the nerves from your neck were severed, cutting off all ties to the adjoining muscles that you now have lost.
I hope I've explained myself thoroughly enough, and even more so, I hope you come back to the forum to see that your post did get aresponse. Welcome!

Edited by qbounce, 01 February 2012 - 03:05 PM.

[Tetracyclone]

Not so, Q. A Chinese surgeon (I think) has pioneered a procedure in which a non-essential peripheral nerve is harvested and used as a bridge between the intact upper cord to a lower peripheral nerve bundle, possible for bridging one or two vertebral spaces. With such a technique a C-2 complete, for instance, can be given good respiratory function or some shoulder function. A C4 might be offered meaningful hand function.

I did not turn up the reference just now when I searched, but I remember it from CureCare.

Mustafa, I suggest you direct your questions to Wise Young over on the Curecare forums. I could be misremembering, but i do not think so...

http://sci.rutgers.e...isplay.php?f=32

[qbounce]

Well then, I stand. . .. Er, sit corrected.
Btw, it's Rutger's CareCure.
Thanks TC, I guess I've got some researching to do.

[physiotherapist]

As a SCI professional I hope I can give some more clarity to this discussion.

I do not know of the surgery you describe in China but I used to work in an upper limb reconstruction clinic at an SCI unit in the UK. We did tendon (muscle) transfers to give tetras greater function but I will hasten to add that it is not for everyone...
1. because it all depends on what muscles you currently have working and
2. because the surgery itself and the following further rehabilitation is time-consuming and can put you out of action and back in hospital for several months.

The way the surgery works is that it takes 'spare' muscles and transposes them so that they play a different role in the arm's function. Take, for example, a C5 complete with elbow flexion but nothing else. There are 2 muscles that bend the elbow so if both are working strongly, one can be taken and repositioned so that it gives you wrist extension as an extra movement thereby developing a tenodesis grip and some hand function (hope it's not too much jargon :-/). Similarly, if someone has a strong deltoid muscle (in the shoulder) one section of the muscle can be transposed so that it gives you active elbow extension and an overhead reach - but this obviously isn't particularly useful unless you have hand function already so it has the biggest functional impact on say a C6/weak C7.

It's definitely very interesting and can have some good results but as I say it will not be appropriate for everyone and even if it is a possibility for you you would need to think carefully about whether or not you want to be hospitalised again.

If people are interested I have the names of some surgeons in the UK and Australia who do this surgery but I am not sure they do private work so I do not know if they could help you. I suppose they might know of others though so message me if you'd like more information.

Edited by physiotherapist, 02 February 2012 - 12:33 PM.

[Tetracyclone]

Q and Physio-

The neurosurgery info I remember is analygous to tendon transfer. The surgeon cited is Chines but has been called to work and teach in a number of countries. I will seek the reference.

The theory is, as you say, not good for many people and works on the basis of "if you have nothing, a little becomes life changing."