Patients with spastic arm paralysis from chronic cerebral injury like a stroke or trauma might benefit from a technique to route a nerve from the nonparalyzed side, suggests a small trial in the New England Journal of Medicine.
Chinese researchers randomized 36 males to undergo 12 months of physical therapy either alone or with contralateral C7 nerve-transfer surgery. The nerve from the nonparalyzed side was rerouted behind the esophagus and attached to the corresponding nerve on the paralyzed side.
At 1 year, the surgery group had greater improvement in upper-extremity function and reduced spasticity, compared with controls; some patients experienced release of spasticity as early as the first postoperative day. Improvements in muscle power and motor function were apparent at 10 months.
Nearly 90% of surgery patients were able to do three of the following tasks at 12 months: dressing, tying shoes, operating a cell phone, and wringing out a towel.