{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T01:29:31Z","timestamp":1794274171928,"version":"4.9.0"},"reference-count":29,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Cervical spinal cord injury (SCI) and lower trunk brachial plexus injury (BPI) commonly result in hand paralysis. Although restoring hand function is complex and challenging to achieve, regaining volitional hand control drastically enhances functionality for these patients. The authors aimed to systematically review the outcomes of hand-opening function after supinator to posterior interosseous nerve (PIN) transfer.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>A systematic literature review was performed according to the PRISMA guidelines.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>A total of 16 studies with 88 patients and 119 supinator to PIN transfers were included (87 transfers for SCI and 32 for BPI). In most studies, the time interval from injury to surgery was 6\u201312 months. Finger extension and thumb extension (Medical Research Council grade \u2265 3\/5) recovered in 86.5% (103\/119) and 78.1% (93\/119) of cases, respectively, over a median follow-up of 19 months. The rates of recovery were similar for the SCI and BPI populations (finger extension, 87.3% in SCI and 84.3% in BPI; thumb extension, 75.8% in SCI and 84.3% in BPI). Type of injury (OR 1.05, 95% CI 0.17\u20136.4, p = 0.95), time from injury to surgery (OR 1.01, 95% CI 0.8\u20131.29, p = 0.88), and age (OR 0.97, 95% CI 0.90\u20131.06, p = 0.60) were not associated with odds of a successful outcome. Duration of follow-up was significantly associated with successful finger extension (OR 1.15, 95% CI 1.01\u20131.30, p = 0.026). No donor-associated supinator weakness was reported postoperatively given that patients had an intact bicep muscle preoperatively contributing to supination.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Supinator to PIN transfer is a safe and effective procedure that can achieve successful restoration of digital extension in the SCI and BPI population at similar rates. Duration of follow-up was associated with superior outcomes, which was expected.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.4.spine231248","type":"journal-article","created":{"date-parts":[[2024,8,3]],"date-time":"2024-08-03T01:54:47Z","timestamp":1722650087000},"page":"621-627","source":"Crossref","is-referenced-by-count":7,"title":["Supinator to posterior interosseous nerve transfer to restore hand opening in brachial plexus and spinal cord injury: a systematic review and individual patient\u2013data meta-analysis"],"prefix":"10.3171","volume":"41","author":[{"given":"Pavlos","family":"Texakalidis","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Northwestern Memorial Hospital, Chicago;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Northwestern Memorial Hospital, Chicago;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantine L.","family":"Karras","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Northwestern Memorial Hospital, Chicago;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tord D.","family":"Alden","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Northwestern Memorial Hospital, Chicago;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin K.","family":"Franz","sequence":"additional","affiliation":[{"name":"Biologics Laboratory, Shirley Ryan AbilityLab, Chicago;"},{"name":"Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago; and"},{"name":"Ken & Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Swong","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Northwestern Memorial Hospital, Chicago;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"7","key":"b1","series-title":"J Hand Surg Am","first-page":"711","article-title":"Spinal cord injury: epidemiology, spontaneous recovery, and hand therapy for the reconstructive hand surgeon","volume":"48","author":"Hill EJR","year":"2023","unstructured":"Hill EJR, Bertelli JA. Spinal cord injury: epidemiology, spontaneous recovery, and hand therapy for the reconstructive hand surgeon. J Hand Surg Am. 2023;48(7):711\u2013718."},{"issue":"1","key":"b2","series-title":"J Neurosurg","first-page":"121","article-title":"Nerve transfers for elbow and finger extension reconstruction in midcervical spinal cord injuries","volume":"122","author":"Bertelli JA","year":"2015","unstructured":"Bertelli JA, Ghizoni MF. Nerve transfers for elbow and finger extension reconstruction in midcervical spinal cord injuries. J Neurosurg. 2015;122(1):121\u2013127."},{"issue":"6","key":"b3","series-title":"Microsurgery","first-page":"696","article-title":"Reconstruction of a C7-T1 brachial plexus lower root injury by transferring multiple nerves and a free gracilis muscle: case report","volume":"40","author":"Soldado F","year":"2020","unstructured":"Soldado F, Ghizoni MF, Bertelli J. Reconstruction of a C7-T1 brachial plexus lower root injury by transferring multiple nerves and a free gracilis muscle: case report. Microsurgery. 2020;40(6):696\u2013699."},{"issue":"1","key":"b4","series-title":"Clin Rehabil","first-page":"3","article-title":"Effects of training on upper limb function after cervical spinal cord injury: a systematic review","volume":"29","author":"Lu X","year":"2015","unstructured":"Lu X, Battistuzzo CR, Zoghi M, Galea MP. Effects of training on upper limb function after cervical spinal cord injury: a systematic review. Clin Rehabil. 2015;29(1):3\u201313."},{"issue":"1","key":"b5","series-title":"Sci Rep","first-page":"3148","article-title":"Independence and upper extremity functioning after spinal cord injury: a cross-sectional study","volume":"13","author":"Lili L","year":"2023","unstructured":"Lili L, Sunnerhagen KS, Rekand T, Alt Murphy M. Independence and upper extremity functioning after spinal cord injury: a cross-sectional study. Sci Rep. 2023;13(1):3148."},{"issue":"5","key":"b6","series-title":"Oper Neurosurg (Hagerstown)","first-page":"E408","article-title":"Supinator to posterior interosseous nerve transfer for restoration of finger extension","volume":"21","author":"Bazarek S","year":"2021","unstructured":"Bazarek S, Sten M, Nin D, Brown JM. Supinator to posterior interosseous nerve transfer for restoration of finger extension. Oper Neurosurg (Hagerstown). 2021;21(5):E408\u2013E413."},{"issue":"1","key":"b7","series-title":"J Neurosurg","first-page":"129","article-title":"Transfer of supinator motor branches to the posterior interosseous nerve in C7-T1 brachial plexus palsy","volume":"113","author":"Bertelli JA","year":"2010","unstructured":"Bertelli JA, Ghizoni MF. Transfer of supinator motor branches to the posterior interosseous nerve in C7-T1 brachial plexus palsy. J Neurosurg. 2010;113(1):129\u2013132."},{"issue":"71","key":"b8","series-title":"BMJ","first-page":"n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page MJ","year":"2021","unstructured":"Page MJ, McKenzie JE, Bossuyt PM,  The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372(71):n71."},{"key":"b9","series-title":"BMJ","first-page":"i4919","article-title":"ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions","volume":"355","author":"Sterne JA","year":"2016","unstructured":"Sterne JA, Hern\u00e1n MA, Reeves BC,  ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016;355:i4919."},{"issue":"6","key":"b10","series-title":"Microsurgery","first-page":"577","article-title":"Functional outcome after transfer of brachialis on anterior interosseous and supinator on posterior interosseous nerves: a preliminary report","volume":"42","author":"Sacco C","year":"2022","unstructured":"Sacco C, Olivi S, Visani J,  Functional outcome after transfer of brachialis on anterior interosseous and supinator on posterior interosseous nerves: a preliminary report. Microsurgery. 2022;42(6):577\u2013585."},{"issue":"11","key":"b11","series-title":"J Hand Surg Am","first-page":"e411","article-title":"Nerve and free gracilis muscle transfers for thumb and finger extension reconstruction in long-standing tetraplegia","volume":"41","author":"Bertelli JA","year":"2016","unstructured":"Bertelli JA, Ghizoni MF. Nerve and free gracilis muscle transfers for thumb and finger extension reconstruction in long-standing tetraplegia. J Hand Surg Am. 2016;41(11):e411\u2013e416."},{"issue":"11","key":"b12","series-title":"Acta Neurochir (Wien)","first-page":"2219","article-title":"Double nerve transfer for restoration of hand grasp and release in C7 tetraplegia following complete cervical spinal cord injury","volume":"160","author":"Emamhadi M","year":"2018","unstructured":"Emamhadi M, Andalib S. Double nerve transfer for restoration of hand grasp and release in C7 tetraplegia following complete cervical spinal cord injury. Acta Neurochir (Wien). 2018;160(11):2219\u20132224."},{"issue":"1","key":"b13","series-title":"Spinal Cord Ser Cases","first-page":"78","article-title":"Using electrodiagnostics to define injury patterns amenable to nerve transfer surgery in tetraplegia: an illustrative case report","volume":"6","author":"Hill EJR","year":"2020","unstructured":"Hill EJR, El-Haj M, Giles JA, Fox IK. Using electrodiagnostics to define injury patterns amenable to nerve transfer surgery in tetraplegia: an illustrative case report. Spinal Cord Ser Cases. 2020;6(1):78."},{"issue":"4","key":"b14","series-title":"J Hand Surg Am","first-page":"e15","article-title":"Double distal intraneural fascicular nerve transfers for lower brachial plexus injuries","volume":"41","author":"Li Z","year":"2016","unstructured":"Li Z, Reynolds M, Satteson E, Nazir O, Petit J, Smith BP. Double distal intraneural fascicular nerve transfers for lower brachial plexus injuries. J Hand Surg Am. 2016;41(4):e15\u2013e19."},{"issue":"4","key":"b15","series-title":"Microsurgery","first-page":"352","article-title":"Selective transfer of nerve to supinator to restore digital extension in central cord syndrome: an anatomical study and a case report","volume":"42","author":"Melamed E","year":"2022","unstructured":"Melamed E, Patel N, Duarte ECW, Nascimento ASCQ, Bertelli JA. Selective transfer of nerve to supinator to restore digital extension in central cord syndrome: an anatomical study and a case report. Microsurgery. 2022;42(4):352\u2013359."},{"key":"b16","series-title":"Surg Neurol Int","first-page":"358","article-title":"Nerves transfers for functional hand recovery in traumatic lower brachial plexopathy","volume":"11","author":"Souza FH","year":"2020","unstructured":"Souza FH, Bernardino SN, Junior ABC,  Nerves transfers for functional hand recovery in traumatic lower brachial plexopathy. Surg Neurol Int. 2020;11:358."},{"issue":"7","key":"b17","series-title":"J Hand Surg Eur Vol","first-page":"717","article-title":"Transfer of the supinator nerve to the posterior interosseous nerve for hand opening in tetraplegia through an anterior approach","volume":"46","author":"van Zyl N","year":"2021","unstructured":"van Zyl N, Galea MP, Cooper C, Hahn J, Hill B. Transfer of the supinator nerve to the posterior interosseous nerve for hand opening in tetraplegia through an anterior approach. J Hand Surg Eur Vol. 2021;46(7):717-724."},{"issue":"4","key":"b18","series-title":"J Hand Surg Am","first-page":"390.e1","article-title":"Nerve transfer of brachialis branch to anterior interosseus nerve using in situ lateral antebrachial cutaneous nerve graft in tetraplegia","volume":"47","author":"Waris E","year":"2022","unstructured":"Waris E, Palmgren-Soppela T, Sommarhem A. Nerve transfer of brachialis branch to anterior interosseus nerve using in situ lateral antebrachial cutaneous nerve graft in tetraplegia. J Hand Surg Am. 2022;47(4):390.e1\u2013390.e7."},{"issue":"2","key":"b19","series-title":"Neurosurgery","first-page":"286","article-title":"Combined nerve and tendon transfers for C7\u2013T1 brachial plexus avulsion injury","volume":"91","author":"Xu B","year":"2022","unstructured":"Xu B, Tong JS, Dong Z, Zhang CG, Gu YD. Combined nerve and tendon transfers for C7\u2013T1 brachial plexus avulsion injury. Neurosurgery. 2022;91(2):286\u2013294."},{"issue":"5","key":"b20","series-title":"J Neurosurg","first-page":"1264","article-title":"Restoration of hand function in C7\u2013T1 brachial plexus palsies using a staged approach with nerve and tendon transfer","volume":"121","author":"Zhang CG","year":"2014","unstructured":"Zhang CG, Dong Z, Gu YD. Restoration of hand function in C7\u2013T1 brachial plexus palsies using a staged approach with nerve and tendon transfer. J Neurosurg. 2014;121(5):1264\u20131270."},{"issue":"10","key":"b21","series-title":"J Hand Surg Am","first-page":"1647","article-title":"Transfer of supinator motor branches to the posterior interosseous nerve to reconstruct thumb and finger extension in tetraplegia: case report","volume":"35","author":"Bertelli JA","year":"2010","unstructured":"Bertelli JA, Tacca CP, Ghizoni MF, Kechele PR, Santos MA. Transfer of supinator motor branches to the posterior interosseous nerve to reconstruct thumb and finger extension in tetraplegia: case report. J Hand Surg Am. 2010;35(10):1647\u20131651."},{"issue":"1","key":"b22","series-title":"J Neurosurg","first-page":"113","article-title":"Clinical use of supinator motor branch transfer to the posterior interosseous nerve in C7\u2013T1 brachial plexus palsies","volume":"113","author":"Dong Z","year":"2010","unstructured":"Dong Z, Gu YD, Zhang CG, Zhang L. Clinical use of supinator motor branch transfer to the posterior interosseous nerve in C7\u2013T1 brachial plexus palsies. J Neurosurg. 2010;113(1):113\u2013117."},{"issue":"5","key":"b23","series-title":"J Neurol Surg A Cent Eur Neurosurg","first-page":"290","article-title":"Relationships between the posterior interosseous nerve and the supinator muscle: application to peripheral nerve compression syndromes and nerve transfer procedures","volume":"74","author":"Tubbs RS","year":"2013","unstructured":"Tubbs RS, Mortazavi MM, Farrington WJ,  Relationships between the posterior interosseous nerve and the supinator muscle: application to peripheral nerve compression syndromes and nerve transfer procedures. J Neurol Surg A Cent Eur Neurosurg. 2013;74(5):290\u2013293."},{"issue":"2","key":"b24","series-title":"J Neurosurg","first-page":"326","article-title":"Anatomical feasibility of transferring supinator motor branches to the posterior interosseous nerve in C7\u2013T1 brachial plexus palsies. Laboratory investigation","volume":"111","author":"Bertelli JA","year":"2009","unstructured":"Bertelli JA, Kechele PR, Santos MA, Besen BA, Duarte H. Anatomical feasibility of transferring supinator motor branches to the posterior interosseous nerve in C7\u2013T1 brachial plexus palsies. Laboratory investigation. J Neurosurg. 2009;111(2):326\u2013331."},{"issue":"2","key":"b25","series-title":"Eur J Trauma Emerg Surg","first-page":"1217","article-title":"Functional outcome predictors after spinal accessory nerve to suprascapular nerve transfer for restoration of shoulder abduction in traumatic brachial plexus injuries in adults: the effect of time from injury to surgery","volume":"48","author":"Solla DJF","year":"2022","unstructured":"Solla DJF, de Oliveira AJM, Riechelmann RS, Martins RS, Siqueira MG. Functional outcome predictors after spinal accessory nerve to suprascapular nerve transfer for restoration of shoulder abduction in traumatic brachial plexus injuries in adults: the effect of time from injury to surgery. Eur J Trauma Emerg Surg. 2022;48(2):1217\u20131223."},{"issue":"1","key":"b26","series-title":"Plast Reconstr Surg","first-page":"184e","article-title":"Current best peripheral nerve transfers for spinal cord injury","volume":"143","author":"Hill EJR","year":"2019","unstructured":"Hill EJR, Fox IK. Current best peripheral nerve transfers for spinal cord injury. Plast Reconstr Surg. 2019;143(1):184e\u2013198e."},{"issue":"4","key":"b27","series-title":"J Neurophysiol","first-page":"847","article-title":"Clinical electrodiagnostic evaluation for nerve transfer surgery in spinal cord injury: a new indication and clinical pearls","volume":"128","author":"Berger MJ","year":"2022","unstructured":"Berger MJ, Adewuyi AA, Fox IK, Franz CK. Clinical electrodiagnostic evaluation for nerve transfer surgery in spinal cord injury: a new indication and clinical pearls. J Neurophysiol. 2022;128(4):847\u2013853."},{"issue":"1","key":"b28","series-title":"J Neurosurg","first-page":"176","article-title":"Nerve transfers for the restoration of hand function after spinal cord injury","volume":"117","author":"Mackinnon SE","year":"2012","unstructured":"Mackinnon SE, Yee A, Ray WZ. Nerve transfers for the restoration of hand function after spinal cord injury. J Neurosurg. 2012;117(1):176\u2013185."},{"issue":"24","key":"b29","series-title":"J Neurotrauma","first-page":"3365","article-title":"Optimizing the timing of peripheral nerve transfers for functional re-animation in cervical spinal cord injury: a conceptual framework","volume":"38","author":"Castanov V","year":"2021","unstructured":"Castanov V, Berger M, Ritsma B, Trier J, Hendry JM. Optimizing the timing of peripheral nerve transfers for functional re-animation in cervical spinal cord injury: a conceptual framework. J Neurotrauma. 2021;38(24):3365\u20133375."}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/41\/5\/article-p621.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/41\/5\/article-p621.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/41\/5\/article-p621.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T13:20:32Z","timestamp":1733491232000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/41\/5\/article-p621.xml"}},"subtitle":["Presented at the 2024 AANS\/CNS Joint Section on Disorders of the Spine and Peripheral Nerves"],"short-title":[],"issued":{"date-parts":[[2024,11,1]]},"references-count":29,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/2024.4.spine231248","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2024,11,1]]}}}