Original Article

Spinal Cord (2009) 47, 334–338; doi:10.1038/sc.2008.148; published online 25 November 2008

Acceptable benefits and risks associated with surgically improving arm function in individuals living with cervical spinal cord injury

K D Anderson1, J Fridén2 and R L Lieber3

  1. 1Department of Neurological Surgery, Reeve-Irvine Research Center, University of California, Irvine, CA, USA
  2. 2Department of Hand Surgery, Sahlgrenska University Hospital, Göteborg, Sweden
  3. 3Department of Orthopaedic Surgery, University of California at San Diego and Veteran Affairs Medical Center at San Diego, La Jolla, CA, USA

Correspondence: Dr KD Anderson, Reeve-Irvine Research Center, Department of Neurological Surgery, 843 Medical Sciences Court, Hewitt Hall, Room 1113, University of California at Irvine, Irvine, CA, 92697-1385, USA. E-mail: kanderso@uci.edu

Received 31 March 2008; Revised 17 October 2008; Accepted 19 October 2008; Published online 25 November 2008.

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Abstract

Study Design:

 

Secure, web-based survey.

Objectives:

 

To determine how quadriplegics in the US view tendon transfer surgeries (TTS) and what activities of daily living (ADL) involving arm/hand function are important in improving quality of life (QoL).

Setting:

 

World wide web.

Methods:

 

Individuals greater than or equal to18 years of age living with a cervical spinal cord injury (SCI). Participants obtained a pass code to enter a secure website and answered survey questions. A total of 137 participants completed the survey.

Results:

 

Two-thirds of participants had injury levels between C4/5 and C5/6. Over 90% felt that improving their arm/hand function would improve their QoL. ADL that were ranked most important to regain were dressing, feeding, transferring in/out of bed, and handwriting. Less than half of the participants had never been told about TTS and only 9% had ever had TTS. Nearly 80% reported that they would be willing to spend 2–3 months being less independent, while recovering from surgery, to ultimately become more independent. Over 75% reported that the ideal time preferred to have TTS, if chosen, would be within 5 years post-injury.

Conclusion:

 

Regaining arm and hand function is of primary importance to individuals with cervical SCI, in particular, to increase independence in multiple ADL. There is a critical need in the US to improve awareness of TTS as a viable option for improving arm/hand function in some people. This information needs to be provided early after injury so that informed choices can be made within the first 5 years.

Sponsorship:

 

Funded by the National Center for Muscle Rehabilitation Research (UCSD-39889) and the Reeve-Irvine Research Center.

Keywords:

cervical spinal cord injury, arm and hand function, tendon transfer surgery, functional independence, activities of daily living, quality of life

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