McKelvey School of Engineering School of Medicine

Restoring arm, hand function after spinal cord injury focus of clinical trial

A patient with a suspected spinal cord injury is carried into a hospital with her head and neck immobilized. Researchers at Washington University School of Medicine in St. Louis are launching a clinical trial to evaluate whether a surgery to reroute nerves around the site of injury can restore hand and arm function in people paralyzed by spinal cord injuries in their necks. (Getty Images)

Spinal cord injuries caused by accidents, violence and disease paralyze from the neck down more than 5,000 people every year. In the first few months after injury, some people regain some movement and sensation in their limbs. Those who do not show improvement in the first few months are unlikely to ever recover.

Now, a team of researchers led by Washington University School of Medicine in St. Louis is launching a phase 2 multicenter clinical trial to assess whether surgically rerouting nerves can restore hand and arm function in people who have suffered spinal cord injuries in their necks. Previous small-scale studies have shown good to excellent results in many surgically treated patients.

“If you ask people with quadriplegia – paralysis of both the arms and the legs – what function they’d most like to get back, they’ll tell you hand and arm function,” said principal investigator Wilson “Zack” Ray, MD, an associate professor of neurosurgery, of biomedical engineering and of orthopedic surgery at Washington University. “It’s more important to many than bladder and bowel control, sexual function or walking. If you have control over your arms and hands, you can get into and out of a wheelchair by yourself, use a cell phone, feed yourself. It gives them a measure of independence. Not everyone who has had the surgery has regained these abilities, but some have.

“In the phase 1 trial we conducted, some people had very profound, dramatic improvements and did very well, and others had very minimal functional improvements that didn’t add to their independence,” Ray continued. “What we hope to do with this phase 2 trial is determine who is most likely to benefit from this procedure.”

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