Carlo SACCO M.D. - EXTRAORDINARY SURGERY: "NERVE TRANSFER" FOR RECOVERY OF THE USE OF HANDS IN QUADRIPLEGIC PATIENTS

SURGERY OF THE PERIPHERAL NERVOUS SYSTEM:
NERVE TRANSFER SURGERY

Quadriplegic patients recover the use of their hands

In May 2012, the news of a quadriplegic patient who after a surgery in the USA at the Barnes-Jewish Hospital in St. Louis, after a year of rehabilitation, was able to bend the thumb and index finger of both hands https://www.corriere.it/salute/disabilita/12_maggio_15/paraplegico-muove-mani-usa_4ff6defe-9e91-11e1...In 2019 the news was released that in Turin, with a brand new surgical technique used in a few centres in the world, they have given back to a quadriplegic patient the use of their hands. They describe it as the first surgery of its kind performed in Italy. Widely disseminated the news on the foremost newscasts and websites such as TGcom24, ANSA, la Repubblica, social networks, etc. One news title: "Turin, quadriplegic recovers the use of hands with an innovative intervention. The method, performed in a few centres in the world and for the first time in Italy, bypasses the lesion of the spinal cord by reconnecting healthy nerves like electrical wires."
In reality, the results can only be evaluated after 8-10 months as correctly reported in the news of the American patient,
In our team, my colleague Dr Sacco Carlo has carried out that type of surgery in quadriplegic patients to recover the use of their hands since 2014. However, in June 2019, the date of the surgery in Turin, Dr Sacco Carlo already had a case series of about ten patients; therefore, the first surgery in Italy, to be honest, was performed in Romagna in 2014.
In the following months and years, our operated patients underwent a clinical and rehabilitation check in collaboration with colleagues from the Montecatone Institute.
We have published these surgical and rehabilitative treatments in the scientific journal “Microsurgery”. The series consists of a group of 11 patients with a treatment of 14 upper limbs and a postoperative observation period of at least 12 months.
One year after surgery, the results show that nerve transfer surgical procedures have significantly improved muscle strength and functional outcomes. Therefore we believe that surgical nerve transfer can represent a milestone in the rehabilitation process.
To appreciate the results of the surgical treatment and the subsequent rehabilitation treatment with the recovery of hand movements, you can view the video, kindly granted by Dr. Olivi Silvia, Head of the Specialist Hospitalization Unit of the MRI of the Montecatone Institute, by clicking in the box below.

Results of surgery and physiotherapy for the recovery of hand use in quadriplegic patients

Video, courtesy of Dr. OLIVI Silvia, Head of the MRI Specialist Unit of the Institute of Montecatone, which allows you to appreciate the recovery of the use of the hand of a quadriplegic patient operated by Dr. SACCO Carlo and subsequently subjected to treatment physiotherapy by Dr. OLIVI Silvia.

webSITE OF MONTECATONE iNstitutE, Imola (BO)

MULTIDISCIPLINARY COLLABORATION FOR ITALIAN EXCELLENCE

Silvia OLIVI M.D., physiatrist, Head of the MRI Specialist Unit of the Institute of Montecatone, has been collaborating for many years with Carlo SACCO M.D., neurosurgeon of our SSD of Peripheral Nervous System Surgery, for the selection of quadriplegic patients who can benefit from the particular surgical technique of NERVE TRANSFER to the upper limbs to recover the use of the hands. 

In addition to selection based on clinical conditions, the most appropriate period for surgical treatment should also be evaluated. 

The results of the surgery can be seen after about a year, while waiting the patient will be followed and subjected to adequate physiotherapy.

Surgical Video:  READ BEFORE CONTINUING

The scenes reproduced in the surgical video on the page below may disturb the sensitivity of visitors.
WHO DECIDES TO ACCESS THE SURGICAL MOVIES IMPLICITLY AGREES TO THE VISION

Based on the anatomical situation and neurological conditions of quadriplegic patients, Carlo SACCO M.D. performs various types of "NERVE TRANSFER" surgery in order to recover the use of the hands. 
In the surgical video, a brachial branch of the MUSCULOCUTANEOUS NERVE is inserted for the ANTERIOR INTEROSSEOUS NERVE to be able to recover the nail flexion of the thumb and index finger.
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 This video is subject to age restrictions and is only available on YouTube. 

English translation of the intraoperative comment in Italian:
Patient of 35 years, six months ago spinal cord trauma with dive C4 fracture, spinal cord injury level C5.
We are doing nerve transfer surgery to try to recover the use of the fingers.
In the surgical field, the median nerve, the branch for the anterior interosseous nerve, the musculocutaneous nerve with the branch for the brachial muscle have been isolated.
The nerves exposed in the surgical field are stimulated at low intensity to demonstrate muscle movement in the brachial muscle and the long flexor muscle of the thumb.
The nerve transfer is then performed from a brachial branch of the musculocutaneous nerve pro anterior interosseous nerve.

THIS VIDEO IS MADE FOR EDUCATIONAL PURPOSES ONLY. PLEASE CONSULT YOUR DOCTOR BEFORE MAKING CARE DECISIONS.
RESTO DEL CARLINO - news city of LUGO (RA)
 24th january 2020

TITLE: "WE TRY TO RECOVER THE USE OF HANDS


LAST UPDATE 6th MAY 2022