Epidural Stimulation for Upper Extremity Function

Inclusion Criteria: * Age ≥18 years and ≤65 * Provides informed consent * History of upper extremity nerve transfer \> 6 months prior to enrollment * Completion of standard post-nerve transfer occupational therapy * Baseline upper extremity strength of \< 5/5 grade with the MRC * Scheduled to undergo a cervical spinal cord stimulation procedure for chronic pain refractory to first line therapy * Willing and able to adhere to the study protocol Exclusion Criteria: * Central nervous system (CNS) malignancy * A contraindication to the SCS procedure * Diagnosis that precludes the patient from full participation in the protocol * A functional implanted device (pacemaker, vagus nerve device, baclofen pump) * Botulinum toxin injection in upper extremity muscles \< 6 months prior to enrollment * For female participants, current/planned pregnancy (females of childbearing age will be asked to take a pregnancy test on the day of the intervention) * Other factors that prevent participation in the opinion of the surgeon-principal investigator