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Team Approach: Treatment and Rehabilitation of Patients with Spinal Cord Injury Resulting in Tetraplegia

Zlotolow, Dan A., MD1,2,3; Lipa, Bethany, MD3; Pahys, Joshua M., MD3,4

doi: 10.2106/JBJS.RVW.18.00009
Team Approach Review Articles

  • » Cervical spinal cord injuries result in limited upper extremity function and often lead to loss of independence.
  • » Tendon and nerve transfers have been shown to reliably improve upper extremity function.
  • » Most patients with injuries at or caudad to the C6 level can become independent through tendon and nerve transfers.
  • » Nerve transfers have expanded the reconstructive options beyond what was available with just tendon transfers and often can allow the patient to obtain 1 or 2 more functions than previously possible.
  • » Patients and physiatrists can be reticent to consider upper limb surgery because they fear compromising long-term function when a cure for spinal cord injury is discovered.

1Temple University School of Medicine, Philadelphia, Pennsylvania

2Hospital for Special Surgery, New York, NY

3Shriners Hospital for Children, Philadelphia, Pennsylvania

4Sidney Kimmel College of Medicine at Thomas Jefferson University, Philadelphia, Pennsylvania

E-mail address for D.A. Zlotolow:

Investigation performed at Shriners Hospital for Children, Philadelphia, Pennsylvania

Disclosure: No funding was received for this manuscript. On the Disclosure of Potential Conflicts of Interest forms, which are provided with the online version of the article, one or more of the authors checked “yes” to indicate that the author had a relevant financial relationship in the biomedical arena outside the submitted work (

Copyright © 2019 by The Journal of Bone and Joint Surgery, Incorporated
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