Surgeons in St. Louis, Missouri, have restored hand function to a 71-year-old paralyzed man — the first reported reactivation of muscles in thumb and forefingers after a spinal-cord injury — thanks to a new operation called a nerve transfer.
The innovative new surgery took a non-functional nerve that usually controls pinching the forefinger and thumb together and "plugging it into a functioning nerve" in the upper arm that had been used for bending the elbow.
"The circuit [in the hand] is intact, but no longer connected to the brain," Ida Fox, MD, assistant professor of plastic and reconstructive surgeon at Washington University and colleague of the surgical team that performed the operation, told the BBC. "What we do is take that circuit and restore the connection to the brain."
Fox added that the surgery can't restore full, normal function to the hand.
After eight months of physical therapy, the patient, who had sustained a spinal-cord injury in a motor vehicle accident in 2008, could move the thumb, index and middle fingers on his left hand. Two months after that, he could do the same on his right.
He can now feed himself and "perform rudimentary writing activities," a press release states.
Had the man been injured higher up along his neck, the surgery would not have been successful. Instead, because his C7 vertebra was injured — the lowest bone in his neck — he still had some function in his shoulders, elbows and wrists.
"The nerve and muscle were still healthy, but the spine injury was blocking communication with the brain," says Fox.
The impressive feat is documented in the Journal of Neurosurgery.
"This is not a small step, this is a significant step," UCLA neurosurgeon Nader Pouratian, MD, a specialist in nerve and movement disorders, told WebMD. "It is a novel application of an established surgical technique. It goes beyond what we thought was possible before."
Fox and her team will soon perform the surgery on a second patient.