Commentary on: Nerve transfers following cervical spinal cord injury: A review and reconstructive algorithm

Nerve transfer includes taking an expandable fascicle from a working nerve to a selective motor branch to restore a vital motor function. Nerve transfer for quadriplegic patients has become an important option that undoubtedly improves the functional capacity of these unfortunate victims. First, I congratulate the authors for choosing such a relevant topic with a great clinical importance. Second, in their nonsystematic literature review, they reviewed the “most relevant” papers in the field; a more exhaustive review would probably add little to their conclusions. The authors also described the priority in treating quadriplegic patients and summarized the different strategies in different clinical scenarios. It is clear that the higher the cervical cord injury, the less the options we have to improve on the clinical function of the patients. Elbow and wrist extension are essential for transfer and operating wheelchair, respectively. More distal hand functions are useful in grasping utensils and picking up objects. Investing time and efforts in restoring such elementary functions can be life-changing. Finally, I congratulate the authors as such a topic is essential to increase the community awareness as both surgeons and caregivers need to be aware of such an important and largely underutilized option.