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Cortical activity and hand function restoration in a patient after spinal cord surgery

Nature Reviews Neurology volume 5, pages 571–574 (2009)Cite this article

Abstract

Background. Following a motorcycle accident, a 9-year-old boy experienced a complete right-sided (dominant) arm and hand paralysis with total sensory loss, Horner syndrome and severe constant pain. This study assessed the long-term outcome of spinal cord surgery undertaken on the patient, focusing on the restored hand function and related cortical activity. The study follows on from previous reports on the same patient.

Investigations. Clinical functional and electrophysiological examinations. Functional MRI of cortical activity.

Diagnosis. Complete brachial plexus (C5–T1) avulsion from the spinal cord.

Management. Spinal cord surgery to restore motor trajectories.

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Figure 1: Assessments of hand function.
Figure 2: Cortical activation demonstrated by functional MRI.

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Acknowledgements

We are much indebted to Professor T. Brismar for performing the neurophysiological studies, to Associate Professor T. Hindmarsh for neuroradiological advice, and to occupational therapists Mrs B. Lindquist and B. Vestin for skilful functional arm and hand assessments. Comments by Professor P. Anand are much appreciated. Written consent for publication was obtained from the patient and parents of the patient.

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Authors and Affiliations

  1. The PNI-Unit, The Royal National Orthopaedic Hospital, Stanmore, UK

    Thomas Carlstedt

  2. Department of Hand Surgery, Karolinska Institute, Södersjukhuset, Stockholm, Sweden

    Tomas Hultgren

  3. Division of Plastic Surgery, Department of Clinical and Experimental Medicine, Hand Surgery and Burns, Faculty of Health Sciences, University Hospital Linköping, Linköping, Sweden

    Torbjörn Nyman & Thomas Hansson

Authors
  1. Thomas Carlstedt
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  2. Tomas Hultgren
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  3. Torbjörn Nyman
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  4. Thomas Hansson
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Correspondence to Thomas Carlstedt.

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The authors declare no competing financial interests.

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Carlstedt, T., Hultgren, T., Nyman, T. et al. Cortical activity and hand function restoration in a patient after spinal cord surgery. Nat Rev Neurol 5, 571–574 (2009). https://doi.org/10.1038/nrneurol.2009.137

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