Patients paralysed by disease, injury could have movement restored by pioneering surgery
Patients whose arms are paralysed by disease or injury could have movement restored by pioneering surgery that ‘hijacks’ nerves and reroutes them.
The experimental procedure, offered at University Hospitals Birmingham National Health Service (NHS) Trust, has already brought what were thought to be ‘dead’ muscles back to life, up to two years after they became immobile.
More than 100 people have had the nerve transfer surgery, including those with spine damage from road accidents, muscle problems due to cancer and spinal arthritis.
This degenerative and progressive joint disease, which is associated with wear and tear and ageing, can affect the spine and lead to arm and leg paralysis in severe cases.
One study has suggested that signs of spinal degeneration linked to arthritis could be present in 90 per cent of over-50s – and increasingly in younger patients.
Singer Robbie Williams, 42, recently admitted to suffering from the condition.
The first symptom is back pain – usually most severe in the morning or after inactivity – and stiffness of the back. Chest and breathing difficulties, and problems with shoulders, hips, arms and knees, are also common.
Physiotherapy, weight loss and anti-inflammatory medications are the first line of treatment.
If the disease is more advanced, fusion of the spine or disc removal or replacement may be an option.
A complication of this type of arthritis is that it results in degenerative discs and tiny pointed outgrowths of bone called spurs – or osteophytes – that can compress and squeeze nerves or the spinal cord.
This kind of pressure can cause numbness, tingling, pain and weakness, and in severe instances limb paralysis. In the case of arthritis of the spine in the neck, arm use can be compromised. Surgery to alleviate compressed spinal nerves can lead to similar problems as, though the nerve cells can regenerate, growth is very slow and muscles can permanently atrophy before this happens.
Mr. Dominic Power, consultant hand and peripheral nerve surgeon explained how the new operation works. He said: ‘In effect, we are rewiring the limbs, by hijacking part of the nerves supplying nearby muscles. We have carried out about 100 of these operations in the past year involving patients with arthritis, degenerative spinal disc disease and spinal fractures.’
So far the procedure has been used to restore movement to both the arms and legs. However, recovery strength in the legs has been less reliable, said Power.
A dozen patients with neck arthritis have had their arm movement restored. In these types of cases, the 45- to 60-minute operation can be carried out under general or regional anaesthetic (a ‘nerve block’), while the patient is awake. First, a small incision is made on the inner aspect of the arm, exposing the musculocutaneous nerve, which runs from the spinal cord in the neck and governs movement of the biceps and triceps in the upper arm.