Spinal Cord Injury – Upper Extremity Reconstruction in Chicago, IL

When a spinal cord injury (SCI) affects your arms and hands, even basic tasks, like feeding yourself, brushing your teeth, or getting dressed, can become a frustrating challenge.

Upper extremity surgery offers the possibility of regaining meaningful function and independence, especially for individuals with cervical spinal cord injuries who still have strength in the shoulders and biceps.

Fellowship-trained plastic and reconstructive surgeon Dr. Lindsay E. Janes specializes in restoring movement and control after spinal cord injury. c

Why Is Upper Extremity Surgery Considered After SCI?

Dr. Janes may recommend surgical reconstruction after a spinal cord injury that leaves you unable to carry out the normal daily activities of living, like eating, grooming, and dressing.

The best surgical candidates are people who experience a cervical spinal cord injury but who retain strength in their shoulder and elbow flexor muscles. It’s important to have this muscle function to participate actively in physical therapy after surgery.

Surgery is considered to:

Improve your ability to perform essential daily tasks like eating, grooming, and dressing
Correct joint deformities caused by spasticity or long-term immobility
Prevent complications such as skin breakdown and contractures due to poor movement

These surgeries are highly personalized and designed to support your goals for daily function and independence.

Surgeries for Upper Extremity Reconstruction After SCI

The best surgical approach depends on your level of injury, overall health, and how much time has passed since your spinal cord injury. Dr. Janes will evaluate your movement, strength, and goals before recommending a treatment plan. Common surgical options include:

Tendon Transfer Surgery: This technique reassigns a functioning muscle to take over the work of a paralyzed one. It can improve elbow extension, pinch, and grip. Tendon transfers can be performed any time after injury, and strength gains are often seen within 12 weeks.

Nerve Transfer Surgery: This approach reroutes healthy nerves from above the level of injury to muscles that have lost function. You must have surgery within six to eight months of the injury to be effective. Recovery is a gradual process, and it may take up to two years to regain full strength.

Tendon Lengthening: For patients with shortened tendons due to long-term stiffness, tendon lengthening can help relax stiffened hands.

Spasticity Surgery (Hyperselective Neurectomy): To reduce involuntary muscle activity, this procedure selectively cuts overactive motor nerve branches. It helps improve control while preserving as much normal movement as possible. Dr. Janes often recommends trying Botox injections, which temporarily reduce movement, in the area first to assess the effectiveness of this approach.

Joint and Bone Surgery: These surgeries help improve alignment and range of motion. In some cases, joint fusion can stabilize the hand in a functional position for better control and strength.

Tendon vs. Nerve Transfer After SCI

Tendon versus nerve transfer is a personal decision that you’ll make collaboratively with Dr. Janes. Each has its benefits and drawbacks.

Surgery Timing: Tendon transfer can occur at any time after the injury, while nerve transfer must be performed within six to eight months. With tendon transfer, only one extremity can be treated at a time; therefore, some patients may require staged surgeries.
Strength Outcomes: Tendon transfer has more reliable strength outcomes, but nerve transfer offers the potential for more independent control of each finger.
Recovery Timeline: Both require therapy. After tendon transfer, many patients experience significant improvement within three months of intensive treatment. With nerve transfer, there are fewer therapy appointments; however, it may take up to a year or two to regain full strength.

Dr. Janes reviews the pros and cons of each surgery related to your unique situation to help guide you.

What to Expect After Surgery

Dr. Janes works with you to design a recovery plan with clear goals and timelines. Some procedures require splinting or casting, and all patients will need post-operative therapy. Most patients experience only mild to moderate pain, which is typically managed with short-term medication.

Surgery Consultations After SCI

Dr. Janes is a fellowship-trained plastic and reconstructive surgeon with unique expertise in upper extremity reconstruction after spinal cord injury.

She compassionately listens, actively supports you, and helps you develop a plan that helps you regain control, improve function, and reclaim your independence.

To schedule your appointment with Dr. Lindsay E. Janes after spinal cord injury, call (312) 695-6022.