Purpose: To review the evidence for interventions in peer-reviewed published literature for reconstructive surgical procedures in the upper extremity for persons with tetraplegia following spinal cord injury (SCI). Method: A critical review and synthesis of articles addressing reconstructive surgical procedures was conducted. Each article was assessed for quality using the Downs and Black evaluation tool. Following this, a level of evidence using a modified Sackett scale was assigned to each intervention within these categories. Results: Each of the surgical procedures reviewed had numerous pre-post or case series studies that provide level 4 evidence (grade C) to support the use of reconstructive surgical procedures in improving upper extremity motor and functional use of the limb in individuals with tetraplegia following an SCI. Conclusion: There is evidence that reconstructive surgical procedures enhance upper extremity function for persons with tetraplegia. Although there is a need for higher quality evidence through improved study designs, there are both ethical and logistical constraints that present challenges in studying this population.

reconstructive surgical procedures, spinal cord injuries, tetraplegia, upper extremity
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