Comparing surgery types
Nerve transfer and tendon transfer are surgeries that can help you improve movement you lost due to SCI. This varies for different people:
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For some people, one may be a better option than the other.
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Some people may have both surgery types.
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Some people may have one type on one side of their body, and the other on the other side of their body.
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Some may even have both types on the same side.
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Compare nerve transfer and tendon transfer
The table below helps you compare nerve transfer and tendon transfer surgeries, and think about if they may be a good option for you.
Questions
Nerve transfer
Tendon transfer
What is the best time after SCI to have surgery?
The option for nerve transfer may be time sensitive.
For some people, tendon transfer may only be an option within 6-12 months after SCI. After that, nerve transfer will not work.
For others, nerve transfer may still be an option even years after their SCI.
Will work at any time after your SCI.
What kinds of movement can surgery help improve?
Fine, coordinated movements, like opening up to shake hands, or use a touchscreen.
Stronger grabbing or pinching movements, like closing fingers to grab and hold onto a wheelchair handle.
What does research show about the outcomes (success) of the surgery?
Research shows that it can improve:
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Hand closing
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Hand opening
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Elbow straightening
There is mixed (or no) research on if it can improve:
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Wrist straightening
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Spreading fingers
Research shows that it can improve:
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Hand closing
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Elbow straightening
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Wrist straightening
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There is mixed (or no) research on if it can improve:
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Hand opening
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Spreading fingers
How long after surgery does it take to gain the movement?
It takes longer after surgery to gain these movements.
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It can take anywhere from
3-12 months or longer.
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Movements you gain can improve for years
after surgery.
It takes less time after surgery to gain movements.
It can take anywhere from 1-3 months, and sometimes longer.
Movements you gain usually stay the same for years
after surgery.
What tests do I need before surgery?
You will need electrodiagnostic testing, also called nerve conduction studies (NCS) and electromyography (EMG). This may tell if nerve transfer is an option for you and how soon you should get surgery.
Usually, no special testing is needed before surgery.
How much pain does surgery cause?
Pain can happen with both surgeries. Most people say they can manage the pain, and it gets better soon after surgery.
How long does it take to heal from surgery?
It takes less time to heal after surgery.
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You can use the arm and hand right away for
light activities.
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You can start weight bearing and sports after about 1 month.
It takes more time to heal after surgery.
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You need to wear a splint or cast for about 2 months.
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You can start weight bearing and sports after about 3 months.
How much rehab will I need, such as occupational therapy and physical therapy, will I need?
People need specialized hand therapy services after surgery. But some people may have trouble getting these services.
Rehab visits 1 time a month and daily exercises at home for 6-12 months.
Rehab is important to check for and learn how to use the new movement.
Doing exercises and rehab can help with more movement even years later.
Some people need rehab in the hospital for a few weeks.
After discharge from the hospital, rehab visits 2-3 times a week and daily exercises at home for 3 months.
Rehab is important to protect the tendons while they heal and learn how to use the new movement.
How can I prepare for surgery and recovery?
Here are tips from people who have had these surgeries:
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Plan to have extra help from a caregiver
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Plan time off work and other activities
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Plan time for therapy and home exercises
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Adjust your wheelchair, such as to switch the controls to the side that isn’t having surgery
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Get a Hoyer lift (a lift that can move you from surface to surface, such as from your bed to a wheelchair) and temporary power wheelchair
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Practice how you will transfer to and from your wheelchair while you protect the arm that had surgery (especially after tendon transfer surgery)
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Think about your bowel and bladder function (especially after tendon transfer surgery)
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Think through travel plans if you are traveling for surgery
The type of surgery that is best for you also depends on things such as the amount of help you can get while you heal from surgery, and how soon you need to get back to your job or school. You can answer some questions to help you think about these things.