171 posters, 10 topics, 5 sessions, 690 authors, 211 institutions

American Association of Plastic Surgeons Meeting 2022

April 9 - 12 | San Diego, California

PC6

Comparing Gains In Function After Traditional Tendon And Novel Nerve Transfer For People With Cervical-Level Spinal Cord Injury

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Poster Presenter

Caitlin Francoisse

Authors

Caitlin Francoisse, Blair Peters, Kashyap Tadisina, Carie Kennedy, Doug Ota, Katherine Stenson, Christine Novak, Katherine Tam, Ida Fox

Affiliations

Division of Plastic Surgery, Saint Louis University School of Medicine, Division of Plastic Surgery, Oregon Health & Science University, Division of Plastic Surgery, Washington University School of Medicine, Palo Alto Veterans' Healthcare System; Division of Physical Medicine and Rehabilitation, Stanford University School of Medicine, St. Louis Veterans' Healthcare System; Division of Physical Medicine and Rehabilitation, Washington University School of Medicine, Division of Plastic Surgery, University of Toronto, Canada, St. Louis Veterans' Healthcare System

Part of Topic

Hand/Extremity

Comparing Gains in Function After Traditional Tendon and Novel Nerve Transfer for People with Cervical-Level Spinal Cord Injury

•Upper extremity function can be improved in people with cervical spinal cord injury (SCI) through tendon (TT) or nerve transfers (NT)1

•TT: reroute expendable donor tendons to recreate a muscle’s function2

•Advantages: rapid results

•Disadvantages: prolonged post-operative recovery

•NT: reroute expendable donor nerves to reinnervate muscle3

•Advantages: faster post-operative recovery

•Disadvantages: longer time to see results

INCLUSION CRITERIA

1.Age >18

2.Mid-level cervical SCI

3.AIS A, B, C

4.>6mo post-injury

EXCLUSION CRITERIA

1.American Spinal Injury Association Impairment Scale (AIS) D

VALIDATED OUTCOME MEASURES

1.SCIM: Spinal Cord Injury Measure

2.SF-36: Short-Form Health Survey5

ALL eligible individuals

Tendon Transfer (TT)

Nerve Transfer (NT)

No Surgery

FOLLOW-UP EVALUATION.

SCIM/ SF-36 Collected

BASELINE EVALUATION

SCIM/ SF-36 Collected

Results:

	TT	NT	No Surgery	All
N	7	10	14	31
Mean Follow-up (months)	15.1	24.3	11.3	16.4
Range (min-max)	(7.6-23.7)	(11.3-37.0)	(6.2-16.8)	(6.2-37.0)

SCIM scores at Baseline versus Follow-up: NT started with lower levels of physical functioning at baseline compared to both the TT and non-surgery groups

Change in SCIM: Both NT + TT groups exhibited gains, not seen in the non-surgery group

No significant changes in SF-36 scores between treatment groups

•Upper extremity reconstruction via TT or NT led to long-term quantifiable gains in function not seen in the non-surgical group

•These functional gains may encourage people with SCI and their providers to consider either surgery based on their values, personal preferences, and their unique circumstances