Francoisse Caitlin A, Peters Blair R, Curtin Catherine M, Novak Christine B, Russo Stephanie A, Tam Katharine, Ota Doug T, Stenson Katherine C, Steeves John D, Kennedy Carie R, Fox Ida K
Division of Plastic Surgery, Saint Louis University, St. Louis, Missouri, USA.
Division of Plastic Surgery, Oregon Health & Science University, Portland, Oregon, USA.
J Spinal Cord Med. 2025 Mar;48(2):300-311. doi: 10.1080/10790268.2023.2283238. Epub 2024 Jan 17.
CONTEXT/OBJECTIVE: To assess short-term changes in health outcomes in people with cervical-level spinal cord injury (SCI) who underwent upper extremity (UE) reconstruction via either novel nerve transfer (NT) or traditional tendon transfer (TT) surgery with individuals who did not undergo UE surgical reconstruction.
Prospective, comparative cohort pilot study.
34 participants with cervical SCI met the following inclusion criteria: age 18 or older, greater than 6 months post-injury, and mid-cervical level SCI American Spinal Injury Association Impairment Scale (AIS) A, B or C.
Two tertiary academic hospitals and their affiliated veterans' hospitals.
Health outcomes were assessed using two previously validated measures, the Spinal Cord Independence Measure (SCIM) and Short-Form Health Survey (SF-36). Demographic, surgical, and survey data were collected at the initial evaluation and one month postoperatively/post-baseline.
34 participants with cervical SCI were recruited across three cohorts: no surgery ( = 16), NT ( = 10), and TT ( = 8). The TT group had a decline in SCIM and SF-36 scores whereas the NT and no surgery groups experienced little change in independence or health status in the immediate perioperative period.
Surgeons and rehabilitation providers must recognize differences in the perioperative needs of people with cervical SCI who chose to have restorative UE surgery. Future work should focus on further investigation of health outcomes, change in function, and improving preoperative counseling and cross-disciplinary management.
背景/目的：评估接受新型神经移植（NT）或传统肌腱移植（TT）手术进行上肢（UE）重建的颈段脊髓损伤（SCI）患者与未接受UE手术重建的患者在健康结局方面的短期变化。
前瞻性、比较性队列试点研究。
34名颈段SCI患者符合以下纳入标准：年龄18岁及以上，受伤后6个月以上，颈段中部水平SCI，美国脊髓损伤协会损伤量表（AIS）为A、B或C级。
两家三级学术医院及其附属退伍军人医院。
使用两种先前验证过的测量方法评估健康结局，即脊髓独立测量量表（SCIM）和简短健康调查问卷（SF-36）。在初始评估时以及术后/基线后1个月收集人口统计学、手术和调查数据。
34名颈段SCI患者被纳入三个队列：未手术组（n = 16）、神经移植组（n = 10）和肌腱移植组（n = 8）。肌腱移植组的SCIM和SF-36评分下降，而神经移植组和未手术组在围手术期即刻的独立性或健康状况几乎没有变化。
外科医生和康复治疗人员必须认识到选择进行恢复性UE手术的颈段SCI患者在围手术期需求上的差异。未来的工作应侧重于进一步研究健康结局、功能变化以及改善术前咨询和跨学科管理。
