The transfer of the nerve, has enabled 13 young people in Australia, to move their paralyzed arms and hands again. To the researchers, the largest case study reports on this topic in The journal “The Lancet”.
The Australian doctors to Natasha van Zyl had surgery 16 young people who were less than a paralyzed one and a half years earlier due to an accident from the neck down. On average, participants were 27 years old. 13 of them were two years after surgery and intense physiotherapy in a position to stretch your elbow and grab things with your Hand.
An exciting Moment
In the case of the operation procedure, the researchers linked by the cross-sectional paralysis deactivated muscles in the Arm or Hand with healthy nervous. For this, they selected a healthy nerve above the injury site of the spinal cord, could still communicate with the brain. This she parted from his actual muscle and associated it instead with the injured nerves, which had controlled the target muscle.
The healthy nerve (green) is on the injury in the spinal cord. For this reason, the brain can still communicate with him. He was connected with an injured nerve (red), its muscle control.
In the Phase after the procedure, the healthy nerve growth on the other nerve fibers to the target muscle, according to van Zyt, he put approximately a Millimeter per day. Depending on which muscle and which nerve it was, it took between three and nine months, until he had reached the target muscle. From that moment on, the patients were able to control the muscle using the nerve again.
“It’s always an exciting Moment for the surgeon, therapist and patient, when you see the first small movement. Normally, there are many happy faces – and sometimes a few tears,” said van Zyl. For many of those Affected to improve the hand functions is an extremely important goal. “This gives them greater independence and the ability to be easier on family and work life,” says the head of the study.
Advantages over the previous approach
By the Transfer of the nerve of the treated patients were able to use independently eat, apply Makeup, and electronic devices, says the study. The control of your elbow will allow you, your wheelchair, self propel and get in your bed, or a car.
So far, researchers have used similar Try usually the Tendons are still healthy muscles and combined these with a paralyzed muscle to move again. The Transfer of the nerve can be achieved, according to the study, similar effects also can be reactivated with a nerve even several muscles at once.
Another advantage is that The engagement is smaller and the Arm must be held after only ten days in a sling, quietly – in the case of a rearrangement of the Tendons six to twelve weeks according to the study, in an orthosis, a flexible Rail.
The limits of the technology
In ten of the study participants the researchers used both techniques – one Arm at a transfer they were nervous and on the other Arm, they camped Tendons. Usually a transplanted tendon resulting in a stronger grip, while a Hand with transf-generated nerve could skilful be controlled, as van Zyl.
People who work with your dominant Hand on the Computer, or a smoother, more natural movements wanted to make, was transferred to this Arm is a nerve. They wanted to use tools or more strength in this Hand develop, transferred the doctors a tendon.
Of the nerve transfer failed, however, in all patients. In three of the Paralytic, he failed, or worked only with complications. We still had to explore to better for which patients the technique is suitable at best, the researchers write. Otherwise, they acknowledged the limits of technology: The method is particularly six to twelve months after the injury makes sense. And also in the case of successful Transfer, it could take months before you see a first movement.
Nevertheless, and despite the small study size, the researchers see an exciting new possibility in technology. The cases examined have shown that the Transfer of nerves combined with the rearrangement of the Tendons could lead to a large improvement for the Affected, said van Zyl.