Cirurgia reconstrutiva pioneira devolve movimento aos braços e mãos de pessoas com lesões na coluna

O procedimento, que geralmente dura quatro horas e permite que o paciente vá para casa no dia seguinte, foi realizado anos após as lesões vertebrais.

Uma técnica cirúrgica pioneira devolveu os movimentos das mãos e braços de pacientes paralisados do pescoço para baixo. Nove tetraplégicos, imobilizados por lesões na coluna vertebral, foram beneficiados pela operação de transferência de nervos feitas por cirurgiões da Universidade de Washington.

Os especialistas redirecionaram os nervos dos braços e mãos dos pacientes e os conectaram a nervos saudáveis. O procedimento permitiu que o cérebro e os músculos voltassem a “conversar” e devolveu aos pacientes a capacidade de desempenhar tarefas que permitem buscar novamente idependência, como se alimentar sozinhos ou escrever com uma caneta.

Os cirurgiões responsáveis informaram que todos os pacientes disseram que as funções de seus braços e mãos melhoraram. O procedimento, que geralmente dura quatro horas e permite que o paciente vá para casa no dia seguinte, foi realizado anos após as lesões vertebrais.

A técnica pode ser indicada para pacientes com lesões nas vértebras C6 ou C7, as mais baixas na região do pescoço. Pessoas que perderam todas as funções dos braços por conta de lesões nas vértebras C1 a C5 não são beneficiadas.

Os cirurgiões redirecionam os nervos saudáveis localizados acima do local lesionado, geralmente nos ombros ou cotovelos, para os nervos paralisados nas mãos ou braços. Uma vez estabelecida a conexão, os pacientes passam por fisioterapia para treinar o cérebro no reconhecimento dos novos sinais dos nervos, um processo que leva de seis a 18 meses.

A professora assistente de cirurgia plástica e reconstrutiva e líder do estudo, Dra. Ida Fox, diz: “Fisicamente, a cirurgia de transferência de nervos oferece melhoras incrementais nas funcionalidades das mãos e dos braços. No entanto psicologicamente estes pequenos passos são muito importantes para a qualidade de vida dos pacientes”.

A cirurgiã plástica relembra um paciente que contou a ela como ele pode pegar um pedaço de macarrão que havia caído em sua blusa. “Antes do procedimento ele não conseguia mover os dedos. Limpar-se sozinho significou muito para ele”, afirma a Dra. Ida.

O objetivo da pesquisa é descobrir uma maneira de devolver os movimentos aos cerca de 250 mil americanos e as outras centenas de milhares de pessoas ao redor do mundo que vivem com lesões na coluna. Enquanto isto não for possível será fundamental criar formas para que a independência em tarefas básicas seja reconquistada, melhorando assim a qualidade de vida destes pacientes.

Outro exemplo dado pela Dra. Ida Fox é a inabilidade de pacientes lesionados na cervical de controlarem seus intestinos e bexigas. “Estas pessoas não têm este controle porque o cérebro não consegue se comunicar com a parte inferior do corpo. Portanto eles não conseguem sentir a necessidade de ir ao banheiro. Em geral estes pacientes precisam da ajuda de um cuidador. No entanto, após esta cirurgia, um dos meus pacientes foi capaz perceber isto após mais de uma década”, conta a cirurgiã plástica, antes de completar: “o aumento de privacidade e espaço pessoal restaura significantemente a dignidade destes pessoas”.

Com informações do Daily Mail. O estudo foi publicado no Plastic and Reconstructive Surgery.


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