Tag Archives: quadriplegia

Nerve Bypass Surgery Restores Hand Movement in Quadriplegic Man

Hand Movement Restored After Spinal Cord Injury

An unnamed 71-year-old quadriplegic man, who was paralyzed from the waist down and had lost all movement of both hands after a car accident, has regained the motor function in his fingers thanks to an experimental surgery that bypasses the damaged nerves.

The patient was paralyzed after a car accident in 2008 and has limited arm, elbow, and shoulder movement. The C7 vertebrae in his spinal cord had been crushed in the accident, and the nerve circuits that send signals from the brain to the muscles in the hands were severed, leaving him without the fine motor movements of the fingers.

Quadriplegic Regains Hand Use from Nerve Trasplant Surgery

“The circuit [in the hand] is intact, but no longer connected to the brain,” Ida Fox, MD, an assistant professor of plastic and reconstructive surgery at Washington University, explained. “What we do is take that circuit and restore the connection to the brain.”

Quadriplegic Regains Hand Movement with Spinal Cord Injury

Luckily, the nearby nerves had not been damaged. Surgeons in the study cut an undamaged nerve from the elbow and rewired it to the damaged nerve that is responsible for moving the muscles of the hand that grasp objects. The undamaged nerve that was cut controlled the man’s brachialis, an arm muscle that helps the elbow to bend.

Quadriplegic Fine Motor Skills After Nerve Bypass Surgery

“We had to sacrifice something that’s ‘sacrificable,'” said Fox.

The surgery was not meant to create an instant fix. By resurrecting the connection between the brain and the hand, the nerve established a new connection to the brain. After the connection was completed, it took nine months of intense physical therapy for the man to regain the ability to use his hands for simple tasks like feeding himself and writing.

Nerve Transplant Bypasses Spinal Cord Injury

“The brain has to be trained to think, ‘OK, I used to bend my elbow with this nerve, and now I use it to pinch,'” said Dr. Fox. “We’re not changing any of the biomechanics; we’re just changing the wiring. So it’s more of a mental game that patients have to play with themselves.”

Nerve Transplant Surgery Restores Hand Movement

The procedure takes advantage of the ability in lower, peripheral nerves to regenerate after being cut, which is not possible in spinal cord nerves.

“Despite years of research, we haven’t figured out how to make the spinal cord work again,” added Fox. “But we know nerves in the peripheral nervous system can regenerate, and that’s what we’re trying to exploit here.”


Tongue Piercing to Improve Wheelchair Mobility

Many Americans live with some form of paralysis. Some have had severe spinal cord injuries, causing paraplegia or quadriplegia, while others’ paralysis is caused by stroke, multiple sclerosis, muscular dystrophy, or cerebral palsy. People who live with these conditions are quite often restricted to a wheelchair for mobility, due to the loss of the use of their legs. Those who are in a wheel chair don’t have many options available to them in order for them to move independently, especially someone who is paralyzed from the neck down and has lost the use of their arms in addition to their legs. There is the “sip and puff” technology, in which the chair is steered by breathing through a straw. Although this method works, it is not very comfortable; it is bulky and can often block the user’s face.

Researchers have now come up with a method they feel may be more comfortable by using a magnetic stud on a tongue ring and a headset with sensors that can pick up the signals from the tongue ring. This, of course, means that those individuals using this device would need to have their tongues pierced. The new tongue drive system was developed by Dr. Maysam Ghovanloo, an assistant professor of electrical and computer engineering at the Georgia Institute of Technology.

Mouth with Tongue Piercing

To test out the equipment, 200 out of 20,000 applicants were selected. Martin Mireles, who has been paralyzed from a spinal injury for almost 20 years now, was recently fitted with the magnetic stud that allows him to steer his wheelchair. He was easily able to guide the wheelchair through an obstacle course lined with trash can, keeping his mouth closed and only needing to shift his tongue to travel in the correct direction.

Researchers chose to utilize the tongue in order to take advantage of some of the functions a severely disabled person still had. The tongue is a very strong muscle; it does not tire easily and is normally unaffected by spinal cord injuries, because it is directly connected to the brain through a cranial nerve. The magnet was first glued to the tongue, but often fell off after just a few hours. Dr. Anne Laumann, an associate professor of dermatology, suggested piercing.

“I think it’s great that something taboo can be used for therapeutic reasons,” Dr. Laumann said.