A pioneering surgical technique has restored some hand and arm movements to patients paralysed from the neck down.

Nine quadriplegics, immobilised by spinal cord injuries in the neck, have benefited from the nerve-transfer operation, performed by surgeons at Washington University.

The specialists redirected peripheral nerves in their patient's arms and hands, by connecting healthy nerves to the injured nerves.

As a result they were able to reintroduce a conversation between the brain and the muscles that allows patients, once again, to accomplish tasks that foster independence, such as feeding themselves or writing with a pen.

Surgeons at Washington University School of Medicine have successfully performed pioneering nerve-transfer surgery on nine paralysed patients, including Dr Michael Bavlsik, who works in the department

The surgeons said all nine of their patients reported improved hand and arm function as a result.

Dr Ida Fox, lead author of the study, and assistant professor of plastic and reconstructive surgery, said: 'Physically, nerve-transfer surgery provides incremental improvements in hand and arm function.

'However, psychologically, these small steps are huge for a patient's quality of life.

'One of my patients told me he was able to pick up a noodle off his chest when he dropped it.

'Before the surgery he couldn't move his fingers. It meant a lot for him to clean off that noodle without anyone helping him.'

Dr Bavlsik was paralysed in a car accident in 2012, but since his surgery he can now feed himself, write with a pen, and drive his eight children around again

Soft nerve bundles make up the human spinal cord.

It acts as the body's control tower, communicating to the brain physical activities both large and small.

The cervical spinal cord, the section in the neck, is comprised of seven vertebra, known as C1 to C7.

Physically, nerve-transfer surgery provides incremental improvements in hand and arm function. However, psychologically, these small steps are huge for a patient's quality of life Dr Ida Fox

Ultimately, the aim of medical research in this area is to discover a way to restore full movement to the estimated 250,000 people in the US, and hundreds of thousands more around the globe, living with spinal cord injuries.

More than half of such injuries involve the neck.

However, until a cure is found, progress in regaining basic independence in routine tasks is vital, to improve patients' quality of life.

One of the most humbling effects of spinal damage is the inability of patients to manage their bladder and bowel functions.

Dr Fox said: 'People with spinal cord injuries cannot control those functions because their brains can't talk to the nerves in the lower body, and they often can't feel the need to go to the bathroom.

'Patients often can't insert a catheter to empty their bladders or insert a suppository for bowel movement and have to rely on help from a caregiver.

'But after this surgery, one of my patients was able to independently catheterise himself, which he hadn't been able to do since his accident over a decade ago.

'This boost in privacy and personal space restores a significant amount of dignity.'

Bypassing the spinal cord, surgeons reroute healthy nerves sitting above the injury site, usually in the shoulders or elbow, to paralysed nerves in the hand or arm. They can currently use the surgery to help those patients who have injured vertebra C6 or C7 in the cervical spine, illustrated

The procedure allowed one patient, a St Louis primary care doctor and father-of-eight to feed himself with a fork, write with a pen, look into patients' ears with a otoscope and rive his children to activities.

In 2012, Dr Michael Bavlsik lost the ability to use his left hand and extend his left elbow while he, his son and a group of Boy Scouts were on a trip in Minnesota.

His van collided with a boat and trailer. None of the boys were severely injured, but the accident left Dr Bavlsik a quadriplegic.

He now relies on a motorised wheelchair to get about.

Dr Bavlsik said: 'Nerve-transfer surgery has been very successful in helping me because it restored triceps function and improvement in my grip.

'I am extremely grateful for this surgery.'

Surgeons hope the technique will one day help restore movement across the body in paralysed patients

Surgeons at Washington University pioneered nerve-transfer surgery.

Developed around 25 years ago by the study's senior author Dr Susan Mackinnon, the technique initially was performed to restore movement in the extremities of patients who had injured peripheral nerves and lost the ability to move a foot or an arm.

But in the last five years, the same technique has been used to restore limited movement to patients with spinal cord injuries.

Patients from Colorado, Michigan and Arizona, among other states, have travelled to St Louis for the surgery.

Dr Mackinnon and Dr Robery Shoenberg, said: 'The gains after nerve-transfer surgery and not instantaneous.

'But once established, the surgery's benefits provide a way to let individuals with spinal cord injuries improve their daily lives.'