Improving hand function in cervical spinal cord injury with nerve transfers and electrical stimulation

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This observational study aims to evaluate the effectiveness of brief intraoperative electrical stimulation and temporary postoperative electrical stimulation in enhancing motor and pain outcomes for patients with cervical spinal cord injuries undergoing nerve transfer surgery. The study will enroll patients who have lost hand function due to cervical spinal cord injury and will assess the impact of these electrical stimulation techniques on their recovery. The researchers hypothesize that these interventions will lead to improved hand function and reduced pain compared to standard nerve transfer surgery alone.

Why it matters

Who can join: the full rules

Inclusion Criteria:

1. Cervical spinal cord injury, ASIA A or ASIA B
2. International Standards for Neurological Classification of Spinal Cord Injury neurological level of injury C6 or C7
3. Agreed upon surgical plan includes at least 1 nerve transfer targeting finger flexion with the anterior interosseous nerve as the recipient and at least 1 nerve transfer targeting finger extension with the posterior interosseous nerve as the recipient
4. Age 18-65 years
5. Mentally and physically able to comply with evaluations and assessments
6. Upper motor neuron pattern of injury in the recipient nerve with planned surgery 36 months or less from the time of injury OR lower motor neuron pattern of injury in the recipient nerve with planned surgery 9 months or less from the time of injury
7. Muscle grade at least 4+/5 on the Medical Research Council (MRC) scale in the territory of the donor nerve(s)
8. Stable function for at least 3 months (i.e., no ongoing recovery)
9. Non-operative rehabilitation for at least 3 months
10. Able to read and write in English at a level necessary to complete the questionnaires

Exclusion Criteria:

1. Contraindication to electrical stimulation, including any implanted electronic device such as a pacemaker or intrathecal drug delivery pump
2. Active infection at the operative site or systemic infection
3. Active malignancy
4. Pregnancy
5. Joint contractures or limited passive range of motion that would limit recovery of function
6. Lack of appropriate social support and/or infrastructure to commit to scheduled follow-up visits
7. Previous tendon transfer or other surgery for restoration of function following cervical spinal cord injury
8. Planned tendon transfer surgery or other surgery for restoration of function following cervical spinal cord injury

Where it's running

• Stanford University/Stanford Health Care
  Palo Alto, California, United States Recruiting

Study contacts

• Principal investigator: Thomas J Wilson, MD, MPH — Stanford University
• Study coordinator: Thomas J Wilson, MD, MPH
• Email: wilsontj@stanford.edu
• Phone: 650-723-6469

Similar studies

Other studies for the same condition or treatment. Recruiting studies are listed first.

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.