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

Anderson KD, Fridén J, Lieber RL.

Spinal Cord, 2009 47(4):334-8. Epub 2008 Nov 25.

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 ≥ 18 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.