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Outcomes of reconstructive hand surgery in patients with tetraplegia and neuropathic pain

Spinal Cordvolume 56pages11941198 (2018) | Download Citation


Study design

Retrospective cohort study


To evaluate the impact of preoperative neuropathic pain on outcome and postoperative compliance after grip reconstructive surgery in people with tetraplegia.


Specialized tetraplegia upper-limb surgery center in Sweden.


All patients who underwent grip reconstructive surgery and attended a 6 month follow up during January 2012 and May 2015 were included. Participants were divided into two groups, pain group and no pain group, based on preoperative rating of experienced pain on a visual analog scale. The main outcome measures were grip strength, grasp ability (Grasp and Release Test) and prioritized activity outcome (Canadian Occupational Performance Measure) together with compliance to the rehabilitation plan.


The study include 37 patients (86% of the cohort). Seventeen patients experienced preoperative pain (46%). There were no differences in outcome between the pain- and the no pain group regarding grip strength (5 vs. 4.6 kg), grip ability or activity performance and satisfaction (COPM improvement of 3.1 vs. 3.0 for performance and 3.6 for both groups in satisfaction). Both groups experienced improvements in all aspects and there were no differences in the ability to fulfill postoperative treatment.


Individuals with tetraplegia and preoperative neuropathic pain in the arm/hand improve after grip reconstructions in a similar way to those without pain. Patients with neuropathic pain therefore should be considered as surgery candidates to the same extent as those without pain.

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Author contribution

JW and JF were responsible for designing the research protocol. JW extracted data, did the preliminary analyse and wrote the report. JF gave feedback on data analyse and report. JW and JF interpreting results and updated reference list.


We thank Promobilia, University of Gothenburg and Sahlgrenska University Hospital for financial support to conduct this study.

Author information


  1. Centre of Advanced Reconstruction of Extremities (CARE), Sahlgrenska University Hospital, Gothenburg, Sweden

    • J. Wangdell
    •  & J. Fridén
  2. Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

    • J. Wangdell
    •  & J. Fridén
  3. Swiss Paraplegic Centre, Nottwil, Switzerland

    • J. Fridén


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Conflict of interest

The authors declare that they have no conflict of interest.

Statement of ethics

We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during the course of this research. Ethical approval was obtained from the Ethic Committee, Gothenburg, Sweden. Number 550-16.

Corresponding author

Correspondence to J. Wangdell.

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