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

Anderson KD, Fridén J, Lieber RL. Acceptable benefits and risks associated with surgically improving arm function in individuals living with cervical spinal cord injury. Spinal Cord 47:334-338, 2009

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|[sol]|hand function are important in improving quality of life (QoL). Setting: World wide web. Methods: Individuals |[ges]|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|[sol]|5 and C5|[sol]|6. Over 90|[percnt]| felt that improving their arm|[sol]|hand function would improve their QoL. ADL that were ranked most important to regain were dressing, feeding, transferring in|[sol]|out of bed, and handwriting. Less than half of the participants had never been told about TTS and only 9|[percnt]| had ever had TTS. Nearly 80|[percnt]| 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|[percnt]| 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|[sol]|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. Spinal Cord (2009) 47, 334–338; doi:10.1038/sc.2008.148; published online 25 November 2008