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Nerve Transfer for High-Level Tetraplegia

This observational study is looking at whether nerve transfer surgeries can improve arm and hand function and quality of life for people with a high-level cervical spinal cord injury (tetraplegia). Specifically, it aims to see if transferring the spinal accessory nerve (SAN) can help reanimate the bicep or tricep muscles and improve independence. You might be able to join if you are 18-80 years old, have a high cervical spinal cord injury (C1-C4 motor level) that is motor complete (AIS grade A-B), and your recovery has plateaued for at least 6 months. Your injury must be between 6 and 60 months old, and you need to have good strength in the donor nerve. The study will measure improvements in elbow strength and independence after surgery. The current status of this study is unclear.

Study design
This is an observational study, meaning researchers will watch and record outcomes without assigning specific treatments. It plans to enroll 30 participants.
What's involved
You would undergo standard pre- and post-operative tests, complete questionnaires, have nerve transfer surgery, and attend follow-up visits with your surgeon for up to 48 months. You would also attend therapy at a local therapist for up to 2 years after surgery.
Compensation
Not stated in the trial record.
Follow-up
Participants will be followed for up to 48 months after surgery to assess outcomes.

AI-generated from the public study record. Only the study team can confirm whether you're eligible — confirm details with them before making decisions.

NCT06288763

Nerve Transfer to Improve Function in High Level Tetraplegia

Recruiting
Not specifiedAges 18–80Observational
Washington University School of Medicine
~30 participants
Updated 2026-03-11 on ClinicalTrials.gov

At a glance

Recruiting sites
9 of 10 listed sites are recruiting right now
RecruitingSuspended, closed, or not yet open
What they're measuring
Elbow Dynamometry
Measured over 36-48 months post-surgery
+3 more outcomes measured

Conditions

Cervical Spinal Cord Injury
Tetraplegia

Explore related trials

Cervical spinal cord injuryQuadriplegia

NCT06288763

Where you'd take part

This study runs at 10 sites. They're the same protocol — you choose where, and that choice sets who your contact draft is addressed to.

  • Houston Methodist

    Houston, Texasstudy coordinator listed

    Recruiting

  • Johns Hopkins University

    Baltimore, Marylandstudy coordinator listed

    Recruiting

  • Stanford University

    Stanford, Californiastudy coordinator listed

    Recruiting

  • University of Alberta

    Edmonton, Alberta, Canadastudy coordinator listed

    Not yet recruiting

  • University of Miami

    Miami, Floridastudy coordinator listed

    Recruiting

  • University of Michigan

    Ann Arbor, Michiganstudy coordinator listed

    Recruiting

  • University of Pennsylvania

    Philadelphia, Pennsylvaniastudy coordinator listed

    Recruiting

  • University of Utah

    Salt Lake City, Utahstudy coordinator listed

    Recruiting

Sites open and close at different times, so the status above is per site — it can differ from the study's overall status.

Study leadership

  • Wilson Z. Ray, MD · PRINCIPAL_INVESTIGATOR · Washington University School of Medicine

Who to contact

Linda Koester, BS
[email protected]
314-362-7368
Email the study team

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Eligibility criteria

Inclusion

18-80 years of age
High cervical SCI (motor level C1-C4)
Motor complete SCI AIS grade A-B
Plateaued spontaneous recovery for at least 6 months of non-operative therapy
SCI greater than 6 months and fewer than 60 months since injury
At least MRC 4/5 donor strength
Mentally and physically willing and able to comply with evaluations

Exclusion

Active infection at the operative site or systemic infection
Any return or ongoing recovery of distal motor function
Significant joint contractures and/or limitations in passive range of motion in the arm
Mentally or physically compromised making it impossible to complete study activities
Immunologically suppressed
Currently undergoing long-term steroid therapy
Active malignancy
Pregnancy

What this trial measures

  • Elbow Dynamometry36-48 months post-surgery

    Change from baseline to 36-48 months post-surgery. Elbow dynamometer measures muscle strength using a handheld portable dynamometer

  • Spinal Cord Independence Measure36-48 months post-surgery

    Change from baseline to 36-48 months post-surgery. SCIM addresses three specific areas of function in patients with SCI, 1) Self-care (feeding, grooming, bathing, and dressing), 2) respiration and sphincter management, and 3) patient's mobility abilities (transfers from bed and indoors/outdoors). SCIM guide clinicians in determining treatment goals/objectives for SCI patients helping therapists assess measurable outcomes in their functional independence. Scores range from 0-100 with a higher score representing better function.

  • Motor strength in medical research council grade (MRC)36-48 months post-surgery

    Change in baseline to 36-48 Months post-surgery. The manual muscle testing is a reliable measure of motor strength when assessed by a trained examiner. Scores range from 0-5, with the highest number representing a better score.

  • Electrodiagnosis (Nerve Conduction Study and Electromyography36-48 months post-surgery

    Change in baseline to 36-48 Months post-surgery. NCS/EMG evaluate neuromuscular health and inform the integrity of lower motor neurons.