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Structured Motor Rehabilitation After Selective Nerve Transfers
Published on: August 15, 2019
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Nerve transfers improve upper limb function in children with acute flaccid myelitis
Marga Serafimova1,2, Justus L Groen1, Martijn Ja Malessy1
1Department of Neurosurgery, Leiden NerveCenter, Leiden University Medical Center, the Netherlands.
Brain & Spine
|December 16, 2025
Summary
Nerve transfer surgery can restore upper limb function in children with acute flaccid myelitis (AFM). Most patients showed improvement, with elbow function transfers yielding better outcomes than shoulder function transfers.
Area of Science:
- Pediatric neurology
- Neurosurgery
- Rehabilitative medicine
Background:
- Acute flaccid myelitis (AFM) is a rare neurological condition impacting the spinal cord.
- AFM can cause significant flaccid weakness and long-term disability in children.
Purpose of the Study:
- To evaluate the efficacy of nerve transfer surgery in restoring upper limb function in children with AFM.
- To analyze surgical outcomes based on the targeted limb function (shoulder vs. elbow).
Main Methods:
- Retrospective review of 8 children with AFM who underwent upper limb nerve transfers between 2016 and 2024.
- Analysis of surgical timing, follow-up duration, and functional outcomes.
Main Results:
- 13 upper limb nerve transfers were performed, averaging 15 months post-onset, with a 27-month follow-up.
- Significant upper limb functional improvement was observed in 7 out of 8 children.
- Nerve transfers targeting elbow function demonstrated superior outcomes compared to those for shoulder function.
Conclusions:
- Selected nerve transfers are a viable and effective method for functional restoration in pediatric AFM patients.
- Challenges in standard nerve transfer applicability due to donor nerve deficits were noted, necessitating alternative approaches.
