The management of the upper limb in incomplete lesions of the cervical spinal cord

Patients with incomplete cervical spinal cord injuries present unique challenges for the reconstructive surgeon. For example, their patterns of injury don't easily fit into the International Classification system familiar to surgeons; they don't lend themselves to a "recipe" approach to surgical decision-making; and they frequently have developed upper limb deformities that must be addressed before any consideration is made for functional surgery. Meanwhile, little has been published regarding surgery for these patients. This article summarizes issues related to evaluating and planning surgical procedures for the upper limb in incomplete lesions of the cervical spinal cord.