Restoring Hand Function Utilizing Nerve Transfers in Persons With Cervical Spinal Cord Injuries

Inclusion Criteria:

- American Spinal Injury Association (ASIA) grade of A, B, or C, or with a diagnosis of
central cord syndrome, showing minimal to no evidence of functional improvement in
motor examination after at least 6 months of non-operative therapy post-injury

- >6 months post-injury

- International Classification of Surgery of the Hand in Tetraplegia (ICSHT) category
0-4

- Cervical spinal cord injury resulting in arm & hand functional impairment, with at
least preserved elbow flexion

- Physically and mentally willing and able to comply with study protocol

- Lives in the immediate area and has no plans to relocate

- Provides informed consent and HIPAA release of medical information

Exclusion Criteria:

- Active infection

- Any return or ongoing clinical recovery of distal motor function within 6 months after
injury

- Physically/mentally compromised

- Systemic disease that would affect the patient's welfare or the research study

- Immunologically suppressed or immunocompromised

- Currently undergoing long-term steroid therapy

- Active malignancy

- Pending litigation or receiving Workers Compensation related to injury or accident

- Pregnancy

- Significant contractures and/or limitations in passive range of motion in the arm or
hand

- Poorly controlled upper extremity spasticity

- Uncontrolled pain or hypersensitivity

- Previous or current injury preventing use of tendon transfers to restore upper
extremity function

- History of brachial plexus injury or systemic neuropathic process

- In the opinion of the Principal Investigator the subject would not be a candidate for
the procedure