Anyone who has been through difficulty knows that it’s the small mercies that matter most. Not everything can be perfect, but a small change—a little taste of how things used to be—can make all the difference.
For people with tetraplegia, or full-body paralysis, this could be as simple as being able to hold a drink or rifle through a wallet to check for change.
Melbourne-based surgeon Dr Natasha Van Zyl has long known this. She’s spent the past few years working on pioneering a form of ‘nerve transfer’ surgery to make such advances a reality.
The idea is to take a functioning nerve from muscles in an unaffected part of the body and reattach it to the paralysed area, bypassing a nerve that doesn’t work. This can ‘reanimate’ forearm muscles, giving people the ability to control their wrist or grip in their hand.
Her team has now performed the operation on 13 young people with an average age of 27 who were paralysed in both their arms and legs. Van Zyl documented the process in a study for the medical journal Lancet, including the “intensive physiotherapy” necessary to help people recover their fine motor skills.
“Extending your elbow allows you to push a wheelchair better, helps you to transfer in and out of a car, reach out and do something in space in front of you, shake someone’s hand,” Van Zyl said, as quoted in The Guardian.
“It allows you to reach above your head, which you need to be able to do because the world is designed for standing-up people. So you can switch a light off, you can get something off a shelf. Hand function is everything you use your hand for.
“You would just need to tape your hands up for five minutes to experience how frustrating life would be without your hands, without your fingers.”
It’s worth bearing in mind that spinal injuries— and tetraplegia—are a wide spectrum, ranging from a complete inability to move any limb, to an ability to walk and use hands but with a limited amount of grip.
The medical paper details examples of patients becoming empowered to go to university to complete a degree or drive a car. It also notes that the procedure is most effective if performed within 12 months of paralysis.
Explaining the human impacts of the study, Van Zyl told The Guardian about someone for whom the nerve transfer was not only life-changing, but also life-saving—empowering him to take his children to the cinema and purchase popcorn and giving back meaning to a life that he thought had been lost.
Similarly, the paper relays the story of someone paralysed in a dirt bike accident who can now lift nine kgs with one hand. He is able to pull apart and put his wheelchair in and out of the car, “pick things off the ground, hold a drink with one hand,” and even live independently.
He continues: “There might be someone else out there who doesn’t see that this is an option. It has made such a big change to my life; hopefully it can help someone else too. It’s really a life-changing thing.”
The procedure is not without risks: The Independent reports that two participants in Zyl’s studies were left with permanent decrease in sensation where their functional nerve was removed.
The paper also quotes doctors that stress that for all its benefits, the method is neither a cure nor a guarantee of returning to the level of control people had previously, but an important demonstration that surgery can return control to the individual.
Michael Acton Smith