Evidence map›Paper›PMID 37981447›Full record

ArticlePediatric neurology2024

Nerve Transfer Surgery in Acute Flaccid Myelitis: Prognostic Factors, Long-Term Outcomes, Comparison With Natural History.

Glenn S Rivera, Jesse A Stokum, Janet Dean, Cristina L Sadowsky, Allan J Belzberg, Matthew J Elrick

Open access · greenAbstract read
In one paragraph

Article in Pediatric neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.0field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Glenn S RiveraDepartment of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Jesse A StokumDepartment of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland.
Janet DeanDepartment of Physical Medicine and Rehabilitation, Kennedy Krieger Institute, Baltimore, Maryland.
Cristina L SadowskyDepartment of Physical Medicine and Rehabilitation, Kennedy Krieger Institute, Baltimore, Maryland.
Allan J BelzbergDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Matthew J ElrickDepartment of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Neurology and Developmental Medicine, Kennedy Krieger Institute, Baltimore, Maryland. Electronic address: Elrick@kennedykrieger.org.
Kennedy Krieger Institute · USJohns Hopkins University · USUniversity of Maryland, Baltimore · US

Funding

Sleep and Circadian Dysfunction, Brain and Neurobehavioral Development in AutismP50HD103538 · NICHD · HUGO W. MOSER RES INST KENNEDY KRIEGER · PI S. Ali Fatemi, Bradley L Schlaggar · 2020 to 2026
$9.9M
NICHD NIH HHS P50 HD103538
6 · The paper itself

Abstract

backgroundNerve transfer surgery is sometimes offered to patients with acute flaccid myelitis (AFM). The objectives of this study were to evaluate surgical efficacy, assess which clinical and neurophysiological data are valuable for preoperative planning, and report long-term outcomes.

methodsThis is a single-center, retrospective case series of patients with AFM who received nerve transfer surgery. All patients had preoperative electromyography and nerve conduction studies (EMG/NCS). Matched control muscles that did not receive nerve transfer surgery were defined in the same cohort.

resultsTen patients meeting inclusion criteria received a total of 23 nerve transfers (19 upper extremity, four lower extremity). The mean age at symptom onset was 3.8 years, surgery was 0.5 to 1.25 years after diagnosis, and mean follow-up was 2.3 years (range 1.3 to 4.5 years). Among muscles with preoperative strength Medical Research Council (MRC) grade 0, muscles receiving nerve transfers performed significantly better than those that did not (MRC grade 2.17 ± 0.42 vs 0 ± 0, respectively, P = 0.0001). Preoperative EMG/NCS predicted worse outcomes in recipient muscles with more abundant acute denervation potentials (P = 0.0098). Donor nerves found to be partially denervated performed equally well as unaffected nerves. Limited data suggested functional improvement accompanying strength recovery.

conclusionsNerve transfer surgery is an effective strategy to restore strength for patients with AFM with persistent, severe motor deficits. Postoperative outcomes in patients with complete paralysis are better than the natural history of disease. This study demonstrates the utility of preoperative clinical and electrophysiological data in guiding patient selection for nerve transfer surgery.

Indexed as

Nerve TransferNeuromuscular DiseasesCentral Nervous System Viral DiseasesChild, PreschoolHumansInfantMyelitisPrognosisRetrospective StudiesAcute flaccid myelitisElectromyographyNerve conduction studyNerve transfer surgerySurgical outcomes

Identifiers

PMID37981447
PMCPMC10894453
OpenAlexW4388037273

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.