Instead of operating on the spine itself, the surgeons rerouted working nerves in the upper arms. These nerves still "talk" to the brain because they attach to the spine above the injury.
Following the surgery, performed at Barnes-Jewish Hospital, and one year of intensive physical therapy, the patient regained some hand function, specifically the ability to bend the thumb and index finger.
The unnamed patient can now feed himself bite-size pieces of food and write with assistance.
"This procedure is unusual for treating quadriplegia because we do not attempt to go back into the spinal cord where the injury is," says surgeon Ida K. Fox, MD, assistant professor of plastic and reconstructive surgery at Washington University.
"Instead, we go out to where we know things work, in this case the elbow, so that we can borrow nerves there and reroute them to give hand function."
The surgery was developed and performed by the study's senior author Susan E. Mackinnon, MD, chief of the Division of Plastic and Reconstructive Surgery at Washington University School of Medicine.
Specialising in injuries to peripheral nerves, she has pioneered similar surgeries to return function to injured arms and legs.