Title: Upper Limb Skeletal Muscle Morphology in Cervical Spinal Cord Injury and Nerve Transfer Surgery
Supervisor: Dr. Cameron Mitchell
Committee member: Dr. Tania Lam, Dr. Michael Berger
Abstract:
Background and aims
Nerve transfer surgery (NTS) is increasingly used to treat patients with cervical spinal cord injury (cSCI), restoring function to muscles of hand opening and closing. NTS involves co-joining a functionally redundant donor nerve from above the level of injury to a paralyzed recipient nerve. However, denervation and pathophysiological changes to muscle morphology renders NTS time sensitive. These maladaptations may influence the viability of the recipient muscle and explain variability in surgical outcomes. To date, no study has directly analyzed upper limb skeletal muscle morphology following cSCI and future research is required to guide NTS clinical decision-making. This research aims to determine the impact of cSCI on muscle morphology in functionally relevant upper limb muscles at ~6 months after traumatic cSCI.
Methods
Muscle tissue will be acquired from flexor carpi radialis and extensor digitorum communis at the time of NTS, with comparison to healthy control tissue acquired at the time of elected forearm surgery. Immunofluorescence and histology will be used to examine fiber size, fiber type, capillarization, fat infiltration, fibrosis, regeneration, and denervation. RNA sequencing will be performed to examine dysregulated pathways and differences in denervation related gene expression.
Significance
This research will provide important insight into denervation related changes in skeletal muscle and help inform NTS clinical decision-making. The current study is part of a larger, ongoing project where our findings will help understand how changes in muscle properties effect outcomes of NTS.