Reconstruction of the Tetraplegic Upper Extremity

Spinal cord injuries (SCI) resulting in Tetraplegia (quadriplegia) occurs most commonly in young, healthy individuals, who are in the prime of their lives; but this can occur in patients of all ages without discrimination of sex, social background, and/or ethnicity and race. The loss of functional use in the upper extremities is perhaps the most disabling of the numerous bodily functions impaired following a spinal cord injury.

In 1998, Dr. Nathan, along with Dr. Ann Vasile, a Long Beach physiatrist with national expertise in the medical management of spinal cord injury and Tetraplegic patients, assembled a multidisciplinary team providing evaluation and surgical reconstruction for appropriate candidates. This team, known as the "Long Beach Memorial Upper Extremity SCI Restoration Team," has also employed other SCI specialists, including occupational therapists, physical therapists, social workers, and nurse case managers, to best optimize SCI evaluation, treatment, and management. The team has provided evaluations for more than 150 Tetraplegic patients referred from local, regional, and national institutions.

Since the inception of this subspecialty service, Dr. Nathan has performed surgical reconstructions in over 50 patients. Indications for surgical reconstruction of the upper extremity in the SCI patient include functional loss of hand and upper extremity function, which interferes with daily activities. Many patients who have sustained a spinal cord injury may benefit from various surgical reconstructions. Those procedures Dr. Nathan has performed include tendon transfers for elbow extension restoration, key pinch and grip reconstructions, contracture releases, Tenodesis procedures, and arthrodesis.

Dr. Nathan also has experience in implantation of a neuroprosthetic systems (Freehand®), which has proven extremely valuable in providing functional hand use in higher levels of SCI patients (levels C5 and C6).

Currently, Dr. Nathan is involved in a national study which entails researching the benefits of implantation of a neuroprosthesis in triceps muscles (for the purposes of providing active elbow extension) in select C5 or C6 Tetraplegic patients.

Please contact our office at (562) 424-9000 to further inquire about the Long Beach Memorial Upper Extremity SCI Restoration Team (meets on a regular basis at Long Beach Memorial Medical Center), and/or if you are interested in receiving further information regarding Dr. Nathan's present national study.