Perceived outcomes and utilization of upper extremity surgical reconstruction in individuals with tetraplegia at model spinal cord injury systems

• Published in: Spinal cord Vol. 42; no. 3; pp. 169 - 176
• Main Authors: BRYDEN, A. M, WUOLLE, K. S, MURRAY, P. K, PECKHAM, P. H
• Format: Journal Article
• Language: English
• Published: London Nature Publishing 01-03-2004; Nature Publishing Group
• Subjects: Activities of Daily Living; Biological and medical sciences; Cerebrospinal fluid. Meninges. Spinal cord; Disabled Persons - psychology; Disabled Persons - rehabilitation; Humans; Medical sciences; Nervous system (semeiology, syndromes); Neurology; Patient Satisfaction - statistics & numerical data; Quadriplegia - etiology; Quadriplegia - physiopathology; Quadriplegia - surgery; Quality of Life; Reconstructive Surgical Procedures - economics; Reconstructive Surgical Procedures - utilization; Rehabilitation Centers; Spinal Cord Injuries - complications; Spinal Cord Injuries - surgery; Treatment Outcome; Upper Extremity - physiology; Upper Extremity - surgery; Human; Tetraplegia; Spinal cord; Nervous system diseases; Prognosis; Vertebral canal; Motor system disorder; Central nervous system; Upper extremity; reconstructive surgery; tendon transfers; Treatment; outcomes; Surgery; Central nervous system disease; Transfer; Neurological disorder; Spinal cord disease; Tendon
• ISSN: 1362-4393; 1476-5624
• DOI: 10.1038/sj.sc.3101579

Survey.
To measure the utilization of upper extremity reconstructive surgery and the clinicians' perceptions of the outcomes provided for persons with tetraplegia across the Model Spinal Cord (SCI) Injury Systems.
Model SCI Systems.
A clinician from each of the Model Centers.
A mailed survey eliciting responses with respect to: (1) utilization of upper extremity reconstructive procedures and (2) the clinicians' perceived outcomes of these procedures.
In all, 76% responded positively about the availability and appropriateness of upper extremity surgical reconstruction at their center. Of the respondents, 75% felt that surgery recipients were generally satisfied with their surgeries, 80% felt that the surgery made a positive impact on recipients' lives, 81% felt that recipients showed increased independence, and 70% reported a positive impact on recipients' occupation. In all, 93% felt insurance companies should pay for the procedures. Compared to the satisfaction of surgery recipients using a similar instrument, clinicians anticipated slightly greater improvements in all areas except occupation.
There is a positive perception of the benefits of reconstructive surgery for tetraplegia; however, procedures are not routinely offered at all centers. The primary reasons reported for this include the misconception that insurance does not remit payment, that a surgeon is not available, and that surgical candidates are referred to another center.