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Early results of nerve transfers for restoring function in severe cases of acute flaccid myelitis.
Pino, Paula A; Intravia, Jessica; Kozin, Scott H; Zlotolow, Dan A.
Afiliação
  • Pino PA; Department of Orthopedic Surgery, Pontifical Catholic University of Chile, Santiago, Chile.
  • Intravia J; Philadelphia Hand to Shoulder Center, Philadelphia, PA.
  • Kozin SH; Department of Orthopedic Surgery, Shriners Hospital for Children-Philadelphia, Philadelphia, PA.
  • Zlotolow DA; Department of Orthopedic Surgery, Shriners Hospital for Children-Philadelphia, Philadelphia, PA.
Ann Neurol ; 86(4): 607-615, 2019 10.
Article em En | MEDLINE | ID: mdl-31355468
OBJECTIVE: To describe early functional outcomes of nerve transfer surgery in a relatively large cohort of patients with acute flaccid myelitis (AFM). METHODS: A retrospective case analysis was made of patients with AFM treated with nerve transfer surgery between 2007 and 2018. Surgical criteria were persistent motor deficits after 6 months from onset and available donor nerves. Thirty-two patients with AFM were evaluated; 16 underwent nerve transfer surgeries. Motor function was evaluated by a licensed occupational therapist using the Active Movement Scale preoperatively and during follow-up examinations. Patients with 6 or more months of follow-up were included in the analysis. Patients with procedures other than nerve transfers were excluded. RESULTS: Sixteen patients with AFM had nerve transfers, with a male predominance (75%) and median age of 2.5 years (range = 4 months-12 years). Eleven patients had a minimum 6 months of follow-up. Nerve transfers to restore elbow function had 87% excellent recovery for elbow flexion and 67% for elbow extension. Finger and thumb extension were full against gravity in 1 patient (100%). Shoulder external rotation was excellent in 50% of patients and shoulder abduction in only 20%. Nine of 10 patients (90%) had resolution of shoulder pseudosubluxation following nerve transfer to the suprascapular nerve. INTERPRETATION: Patients with AFM with persistent motor deficits 6 to 9 months after onset benefit from nerve transfer surgery. Restoration of elbow function was more reliable than restoration of shoulder function. We recommend early referral of patients with incomplete recovery to a center experienced in nerve transfers for timely evaluation and treatment. ANN NEUROL 2019;86:607-615.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transferência de Nervo / Recuperação de Função Fisiológica / Viroses do Sistema Nervoso Central / Mielite / Doenças Neuromusculares Tipo de estudo: Observational_studies Limite: Child / Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: Ann Neurol Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Chile País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transferência de Nervo / Recuperação de Função Fisiológica / Viroses do Sistema Nervoso Central / Mielite / Doenças Neuromusculares Tipo de estudo: Observational_studies Limite: Child / Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: Ann Neurol Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Chile País de publicação: Estados Unidos