Nerve transfers improve upper limb function in children with acute flaccid myelitis

Brain and Spine, vol. 5, pp. 105876

Abstract

Acute flaccid myelitis (AFM) is a rare disease affecting the spinal cord resulting in flaccid weakness that may involve any limb and can lead to significant long-term sequalae. Collected were results on children affected with AFM who were treated with nerve transfer surgery between 2016 and 2024 in a tertiary referral centre. Eight children underwent 13 upper limb nerve transfers. Surgery was performed on average 15 months after disease onset. The average follow-up time was 27 months. All but one child showed improvement in upper limb function following surgical intervention. Procedures directed at elbow function deficits had better functional outcome compared to nerve transfers for shoulder function. Standard nerve transfers used for brachial plexus injuries were often not possible in these children due to donor nerve deficits. Alternative and less utilised transfers are discussed. We concluded that selected nerve transfers are a reliable method to restore function in children with AFM. • Acute flaccid myelitis (AFM) is a rare disease affecting peripheral nerve function in children • We describe the first report from a European center on 13 nerve transfers for upper limb function restoration in AFM • Nerve transfer surgeries contributed to functional improvement of the arm in selected patients • Nerve transfers that have become standard for brachial plexus injuries are not always possible in AFM

Authors 4

1. Marga Serafimova Aachen Department of Neurosurgery, Leiden NerveCenter

   Tel Aviv Sourasky Medical Center · Leiden University Medical Center

   Affiliation as printed

   Department of Neurosurgery, Leiden NerveCenter, Leiden University Medical Center, the Netherlands

   Department of Neurosurgery, Peripheral Nerve Unit, Tel Aviv Sourasky Medical Center, Israel

2. Justus L Groen Aachen Department of Neurosurgery, Leiden NerveCenter

   Leiden University Medical Center

   Affiliation as printed

   Department of Neurosurgery, Leiden NerveCenter, Leiden University Medical Center, the Netherlands

3. Martijn J. A. Malessy Aachen Department of Neurosurgery, Leiden NerveCenter

   Leiden University Medical Center

   Affiliation as printed

   Department of Neurosurgery, Leiden NerveCenter, Leiden University Medical Center, the Netherlands

4. Willem Pondaag corresponding Aachen Department of Neurosurgery, Leiden NerveCenter

   Leiden University Medical Center

   Affiliation as printed

   Department of Neurosurgery, Leiden NerveCenter, Leiden University Medical Center, the Netherlands