PATIENT SELECTION FOR AN UPPER EXTREMITY NEUROPROSTHESIS IN TETRAPLEGIC INDIVIDUALS

One hundred and twenty persons with new onset traumatic tetraplegia co nsecutively admitted to our rehabilitation service were screened for c onsideration for use of an upper extremity neuroprosthesis. Strict inc lusion criteria allowed only for participation of patients with ASIA i mpairment scale A, B or C injuries at the C5 or C6 level. One hundred and six persons were excluded from participation for the following rea sons: five patients died, 27 had central cord syndrome, two had Brown- Sequard syndrome, 12 were injured at too high a level, 42 were injured at too low a level, two were excluded on the basis of motor incomplet eness alone, four were excessively denervated, two had limited range o f motion, one had overriding medical complications, seven had psychoso cial issues making participation impractical, and two elected tendon t ransfer surgery. In total, 14 patients (representing 11.7% of all tetr aplegic individuals and 50% of the C5 or C6 ASIA Impairment Scale A, B or C patients) were found to be candidates for the neuroprosthesis. G iven the prevalence of tetraplegia, approximately 12,200 Americans wou ld be candidates for the FES neuroprosthetic hand grasp system under t he current research protocols. With both the expansion of current prot ocols to other diagnostic categories and further research and developm ent, application of this neuroprosthesis to a considerable number of p reviously excluded subjects will likely be possible.