Spinal Cord Injury – Upper Extremity Reconstruction in Chicago, IL
A spinal cord injury can affect much more than mobility in the legs. When the injury involves the cervical spine, weakness or paralysis in the arms and hands can make everyday tasks like eating, dressing, grooming, transferring, or using a wheelchair much harder.
For some patients, upper extremity reconstruction can help restore specific movements and improve independence while managing this condition. Dr. Lindsay E. Janes is a fellowship-trained plastic and reconstructive surgeon with advanced training in hand and peripheral nerve surgery. She evaluates which muscles and nerves remain functional and develops a surgical plan based on the movements that matter most in each patient’s daily life.
Why Is Upper Extremity Surgery Considered After SCI?
Upper extremity reconstruction may be considered when a spinal cord injury limits the ability to use the arms or hands for important daily activities. The goal is not to return the arm or hand to exactly how it functioned before the injury. Instead, surgery focuses on restoring selected movements that can make daily life easier and more independent.
Patients with cervical spinal cord injuries may still have useful strength in certain muscles above the level of injury. Those functioning muscles or nerves can sometimes be redirected to help restore movement elsewhere.
Surgery may be used to:
- Improve pinch, grip, or elbow movement
- Make eating, grooming, dressing, and transfers easier
- Improve the position of a stiff or contracted hand
- Reduce problems caused by severe spasticity
- Support more independent wheelchair use and other daily activities
Dr. Janes considers remaining muscle strength, joint flexibility, spasticity, overall health, and rehabilitation goals when determining whether surgery may be appropriate.
Surgeries for Upper Extremity Reconstruction After SCI
No single procedure fits every spinal cord injury. Dr. Janes examines which muscles are still working, which movements are limited, and what functions would provide the greatest benefit before recommending treatment.
Common options include:
- Tendon Transfer Surgery: A functioning muscle and tendon are redirected to perform a movement that has been lost. Tendon transfers may help improve elbow extension, grip, or pinch and can remain an option long after the original injury.
- Nerve Transfer Surgery: A working nerve is redirected to a nerve that controls a weakened or paralyzed muscle. Because muscles can lose their ability to respond after prolonged loss of nerve input, nerve transfers are time-sensitive and should be evaluated as early as possible after injury.
- Tendon Lengthening: Spasticity and prolonged immobility can cause tendons to shorten and joints to become difficult to position. Lengthening selected tendons may improve hand position, flexibility, or ease of care.
- Spasticity Surgery: Hyperselective neurectomy reduces signals traveling through selected motor nerve branches that contribute to excessive muscle activity. Dr. Janes may first recommend Botox injections to temporarily reduce activity in the targeted muscles and help determine whether a more lasting surgical approach could be beneficial.
- Joint and Bone Surgery: Procedures involving the joints or bones may improve alignment, stability, or positioning. In some cases, joint fusion can place the hand or wrist in a more useful position for grip, transfers, or other activities.
How Does Dr. Janes Plan Upper Extremity Reconstruction?
Surgical planning begins with the activities a patient wants to improve. For one person, the priority may be extending the elbow for wheelchair mobility or transfers. For another, improving pinch or grasp may make it easier to eat, hold a phone, write, or complete personal care.
Dr. Janes evaluates muscle strength, joint motion, nerve function, spasticity, and the condition of the surrounding tissues. Nerve studies or other testing may also be used when needed.
Some patients may benefit from one procedure, while others may require a combination of tendon, nerve, joint, or spasticity treatments. The plan is tailored to create useful movement rather than simply increasing strength in isolation.
What to Expect After Surgery
Recovery depends on the type of reconstruction performed. Some procedures require a splint or cast while tissues heal, and rehabilitation is an important part of recovery after both tendon and nerve transfer surgery.
Therapy helps protect the surgical repair while teaching the body how to use the reconstructed movement. After a tendon transfer, patients must learn to use a muscle in a new way. Following a nerve transfer, improvement develops more gradually as nerve fibers grow toward the target muscle and the brain learns to control the new movement.
Dr. Janes works closely with patients and their therapists to establish realistic goals and a rehabilitation plan based on the procedure performed.
Spinal Cord Injury FAQs
Am I Too Late to Consider Upper Extremity Reconstruction After a Spinal Cord Injury?
Not necessarily. Timing depends on the procedure being considered. Nerve transfers are more time-sensitive because muscles that remain without nerve input for too long may become less responsive to reinnervation.
Tendon transfers, joint procedures, and some spasticity surgeries may still be options years after an injury. Dr. Janes evaluates muscle strength, joint flexibility, nerve function, and overall health to determine which approaches may still provide useful improvement.
Can Surgery Improve Hand Function After a Spinal Cord Injury?
It may. Surgery can sometimes restore specific movements such as pinch, grasp, wrist control, or elbow extension. The amount of improvement depends on the injury level, which muscles and nerves remain functional, and the type of reconstruction performed.
The goal is to create practical improvements that make daily activities easier, not to recreate normal hand function.
Is Surgery an Option for Hand Paralysis After Spinal Cord Injury?
For some patients, yes. Cervical spinal cord injuries can leave certain muscles and nerves functioning while others lose movement. Those remaining sources of strength may sometimes be redirected through tendon or nerve transfers.
Dr. Janes evaluates which muscles are available and whether they can be used to restore a specific movement that would improve independence.
How Soon After a Spinal Cord Injury Should I See a Reconstructive Surgeon?
Early evaluation is helpful because certain procedures have limited treatment windows. Nerve transfers generally need to be considered sooner than tendon transfers because the target muscles must remain able to respond to new nerve input.
An early consultation does not necessarily mean surgery must happen immediately. It allows Dr. Janes to evaluate available options, monitor recovery, and determine whether reconstruction may be beneficial.
What Determines Whether I Qualify for Tendon or Nerve Transfer Surgery?
Candidacy depends on several factors, including remaining muscle strength, nerve function, joint flexibility, overall health, and the ability to participate in rehabilitation.
Dr. Janes performs a detailed physical examination and may use nerve studies or other testing to determine which muscles or nerves could potentially be redirected.
What Improvements Are Realistic After Surgery for Spinal Cord Injury?
Results vary depending on the injury and the type of reconstruction. Potential improvements may include stronger pinch or grip, better elbow extension, easier wheelchair use, or greater independence with eating, grooming, dressing, and transfers.
Surgical planning focuses on the movements that are most likely to make a practical difference in daily life.
How Important Is Hand Therapy After Spinal Cord Injury Surgery?
Therapy is an essential part of recovery. The muscles and nerves involved in reconstruction must be retrained to perform movements differently than they did before surgery.
Consistent rehabilitation can improve coordination, protect the surgical repair, and help patients make the most of the movement restored through surgery.
Why Choose Dr. Lindsay E. Janes for Upper Extremity Reconstruction?
Dr. Lindsay E. Janes has specialized training in plastic and reconstructive surgery, hand surgery, and peripheral nerve reconstruction. After completing her plastic surgery residency at the McGaw Medical Center of Northwestern University, she pursued fellowship training in hand and peripheral nerve surgery at the University of Pennsylvania, including advanced experience with nerve transfers and brachial plexus reconstruction.
She is also an Assistant Professor of Surgery at Northwestern University Feinberg School of Medicine and is involved in clinical care, research, and surgical education. Her background in peripheral nerve repair, spasticity treatment, tendon reconstruction, and complex upper extremity conditions allows her to approach spinal cord injury reconstruction from several angles. Treatment planning centers on the functions that matter most to each patient and the movements that can support greater independence.
Explore Upper Extremity Reconstruction in Chicago, IL
Upper extremity reconstruction may help restore specific movements that make daily activities easier after a cervical spinal cord injury. Dr. Janes evaluates each patient’s remaining strength, nerve function, mobility, and goals to determine which surgical options may be appropriate.
To learn more about spinal cord injury reconstruction in Chicago, call (312) 695-6022 to schedule a consultation with Dr. Lindsay E. Janes.