Surgeons in Australia have successfully rewired the nerves inside some paralyzed patients’ bodies to restore movement to their arms and hands. The success was accomplished using nerve transfer surgery, a technique pioneered on spinal cord injuries by Australian surgeons. Natasha van Zyl, a plastic and reconstructive surgeon at Austin Health in Melbourne, led the research. The pioneering surgery has been described in medical journal The Lancet.
Australian surgeons recruited 16 young adults with tetraplegia (paralysis of both the upper and lower limbs) for the study. Most had been injured in car accidents, playing sports, or through falls. The three women and 13 men were assessed on their ability to complete tasks before and after surgery.
The patients underwent single or multiple nerve transfers in one or both upper limbs. In 10 of the participants, nerve and tendon transfers were combined to allow different types of movement in each hand. The two techniques have different advantages. Nerve transfers restore more natural movement and finer motor control. Tendon transfers restore more power and heavy lifting ability.
The surgery ultimately enabled 13 of the participants to regain movement and function in their elbows and hands. For best results, the study found nerve transfers should be performed within six to 12 months of a spinal injury. Two participants had a temporary decrease in wrist strength that resolved itself by a year after the surgery. Three participants had four failed nerve transfers and two had a permanent decrease in sensation.
The therapy could have a life-changing impact for paralyzed people, but there are some issues that still must be worked out. The technique has limitations and does not work on all patients. According to Van Zyl, additional research is needed to figure out how to optimize the nerves before transferring them. Researchers also want to be able to predict more accurately who would benefit from the surgery.