Nerve Transfers for Spinal Cord Injuries
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Purpose
Nerve Transfer surgery can provide improved hand function following cervical spinal cord injuries
| Condition | Intervention |
|---|---|
|
Spinal Cord Injury |
Procedure: Nerve Transfer |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Restoring Hand Function Using Nerve Transfers in Persons With Spinal Cord Injury |
- Change in upper motor strength [ Time Frame: 24 months ] [ Designated as safety issue: No ]Patients motor strength will be assessed over 24 months of clinical follow-up with conventional manual motor testing
- Change in Disabilities of Arm, Shoulder, and Hand (DASH) scores [ Time Frame: 24 months ] [ Designated as safety issue: No ]Pre-operative, 3, 6, 12, and 24 month
- Change in Short Form 36 (SF-36) scores [ Time Frame: 24 months ] [ Designated as safety issue: No ]The change in SF-36 scores will be followed over time and assessed pre-operatively, 3,6,12, and 24 months post-operatively.
- Rates of Intraoperative and Post-operative complications [ Time Frame: 24 months ] [ Designated as safety issue: No ]
- Effect of timing on surgical intervention [ Time Frame: 24 months ] [ Designated as safety issue: No ]Assess the effect of timing on primary and secondary outcome measures, early (<12 months) vs. (>12 months)
| Estimated Enrollment: | 20 |
| Study Start Date: | October 2012 |
| Estimated Study Completion Date: | October 2016 |
| Estimated Primary Completion Date: | October 2016 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Nerve Transfer
Surgical - Nerve transfers for patients with stable cervical spinal cord injuries
|
Procedure: Nerve Transfer
A single nerve transfer will be offered to the surgical group, the brachialis branch to the anterior interosseous nerve.
|
Detailed Description:
Current treatment strategies of acute cervical spinal cord injuries remain limited. Treatment options that provide meaningful improvements in patient quality of life and long-term functional independence will provide a significant public health impact.
Specific Aim: Measure the efficacy of nerve transfer surgery in the treatment of patients with complete cervical spinal cord injuries with no hand function. Optimize the efficiency of nerve transfer surgery by evaluating patient outcomes in relation to patient selection and optimal timing the the surgery. Hypothesis: Peripheral nerve transfers in patients with spinal cord injuries will improve hand function and provide improvement in patient quality of life and functional independence.
Eligibility| Ages Eligible for Study: | 18 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Cervical spinal cord injury ASIA A-B resulting in hand functional impairment
- No evidence of clinical recovery with at least 6 months of non-operative therapy
- Normal elbow and shoulder strength and range of motion
- 18-65 years of age
- Physically and mentally willing to comply with post-operative therapy and evaluations
- Lives in the immediate area with no plans to relocate
Exclusion Criteria:
- Associated brachial plexus injury
- Associated moderate to severe head injury
- Fractures in the upper extremities, joint instability or joint contractors
- Significant pain or hypersensitivity
- Active local or systemic infection
- Active malignancy
- Pregnant
Contacts and Locations| Contact: Wilson Ray, MD | 314-362-3577 | rayz@wudosis.wustl.edu |
| Contact: William Janes, OTD, MSCI | 314-289-4270 | janesw@wusm.wustl.edu |
| United States, Missouri | |
| Washington University | Recruiting |
| St. Louis, Missouri, United States, 63110 | |
| Contact: William Janes, OTD, MSCI 314-289-4270 janesw@wusm.wustl.edu | |
| Principal Investigator: Wilson Ray, MD | |
| Sub-Investigator: Jack Engsberg, PhD | |
| Sub-Investigator: William Janes, OTD, MSCI | |
| Principal Investigator: | Wilson Z Ray, MD | Washington University, St. Louis |
More Information
No publications provided
| Responsible Party: | Washington University School of Medicine |
| ClinicalTrials.gov Identifier: | NCT01714349 History of Changes |
| Other Study ID Numbers: | NTSCI |
| Study First Received: | October 22, 2012 |
| Last Updated: | December 19, 2012 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Washington University School of Medicine:
|
Spinal cord injury nerve transfer tetraplegia |
Additional relevant MeSH terms:
|
Spinal Cord Injuries Spinal Cord Diseases Central Nervous System Diseases |
Nervous System Diseases Trauma, Nervous System Wounds and Injuries |
ClinicalTrials.gov processed this record on May 23, 2013