Improvement of urological-management abilities in individuals with tetraplegia by reconstructive hand surgery

Abstract

Objective: To evaluate whether reconstructive hand surgery could improve the ability of tetraplegic patients to perform clean intermittent self-catheterization (CIC). Materials and methods: The subjects were patients with complete traumatic tetraplegia admitted to the Nagano Rehabilitation Center between 1977 and 1996. A total of 63 subjects were included in this study with an age range of 18 ± 73 years (mean 38.2 years). Reconstructive hand surgery was performed on 44 hands (28 cases). Current urological conditions were assessed by interview or mail questionnaire. Results: Fifty-one per cent (22/43) of the patients with C6 level of tetraplegia and 86% (12/ 14) of those with C7 or C8 neurological level of injury could perform CIC independently and only one subject needed assisted CIC. Conclusion: CIC is the preferred option for people with tetraplegia. Reconstructive hand surgery is thus recommended to make urological management more independent for a selected group of people with tetraplegia. Spinal Cord (2000) 38, 541 ± 545

Complications of sacral anterior root stimulator implantation in a cervical spinal cord injury patient: increased spasms requiring intrathecal baclofen therapy followed by delayed fracture of lumbar spine leading to intractable spasms compelling disuse of the sacral anterior root stimulator

“…In the patients with tetraplegia, reconstructive hand surgery has been shown to improve the ability to perform clean intermittent self-catheterisation. 9 Thus, increasingly larger number of tetraplegic patients may be able to manage their bladders by intermittent catheterisation with antimuscarinic therapy. Therefore, we believe that the indications for implantation of SARS in spinal cord injury patients are becoming limited.…”

Self-catheterization acquisition after hand reanimation protocols in C5–C7 tetraplegic patients

“…8 In contrast, the majority of C8 level patients can perform ISC with active pinch and grasp holds. 9 Hand function can be improved by upper limb reanimation (ULR) protocols consisting of reconstructive surgery 10,11 (tendon transfers, tenodeses and arthrodeses) combined with specific rehabilitation procedures (tasked motor training, biofeedback and new muscle-function integration). 12 These protocols improve hand abilities, activities of daily living (ADL) and quality of life (QoL).…”

“…13,14 To our knowledge, the contribution of ULR to the acquisition of ISC has not been specifically addressed in the literature in traumatic tetraplegics. 9,15 The objective of our study was to assess the efficacy of ULR protocols on acquisition of ISC in tetraplegic C5-C7 ASIA patients.…”

Tetraplegia Hand Activity Questionnaire (THAQ): the development,assessment of arm–hand function-related activities in tetraplegic patients with a spinal cord injury

“…2,17,32,[42][43][44] Therefore, we are interested in a rehabilitation outcome measure that also indicates the effectiveness of treatment in terms of gained and lost activities important in the daily life of the patient.…”