Restoring Hand Function Utilizing Nerve Transfers in Persons With Cervical Spinal Cord Injuries

Inclusion Criteria: * American Spinal Injury Association (ASIA) grade of A, B, or C, or with a diagnosis of central cord syndrome, showing minimal to no evidence of functional improvement in motor examination after at least 6 months of non-operative therapy post-injury * \>6 months post-injury * International Classification of Surgery of the Hand in Tetraplegia (ICSHT) category 0-4 * Cervical spinal cord injury resulting in arm \& hand functional impairment, with at least preserved elbow flexion * Physically and mentally willing and able to comply with study protocol * Lives in the immediate area and has no plans to relocate * Provides informed consent and HIPAA release of medical information Exclusion Criteria: * Active infection * Any return or ongoing clinical recovery of distal motor function within 6 months after injury * Physically/mentally compromised * Systemic disease that would affect the patient's welfare or the research study * Immunologically suppressed or immunocompromised * Currently undergoing long-term steroid therapy * Active malignancy * Pending litigation or receiving Workers Compensation related to injury or accident * Pregnancy * Significant contractures and/or limitations in passive range of motion in the arm or hand * Poorly controlled upper extremity spasticity * Uncontrolled pain or hypersensitivity * Previous or current injury preventing use of tendon transfers to restore upper extremity function * History of brachial plexus injury or systemic ne…