Surgeon Restores Movement to Children with Polio-Like Illness

A New York City orthopedic surgeon, using a complex and innovative technique, has successfully restored muscular function to young patients who have a devastating neurological illness that resembles polio.
Dr. Scott Wolfe is a specialist in nerve transfer surgery at the Hospital for Special Surgery (HSS) in New York and director of the HSS Center for Brachial Plexus and Traumatic Nerve Injury.
The illness is acute flaccid myelitis, or AFM, an inflammation of the spinal cord that appears to occur after a viral infection.
This week, the Centers for Disease Control and Prevention (CDC) reported there were 201 confirmed cases of AFM in 40 states last year. That compares with 35 cases in 2017 and 149 cases in 2016.
“Most affected patients are children and teenagers,” Wolfe told Healthline. “Within a day or two, nearly all experience rapid, progressive paralysis — a partial or complete loss of muscle function in their arms or legs.
“While some patients regain function, many suffer some degree of permanent paralysis. No nonsurgical treatment has been shown to be effective,” he said.
To perform a nerve transfer, Wolfe takes all or part of a working nerve with a less important or redundant function and transfers it to reestablish function in a paralyzed muscle.
Wolfe has restored arm movement and function in young AFM patients who were previously told their paralysis would be permanent.
The journal Pediatric Neurology has published a study that details Wolfe’s work with two patients, ages 12 and 14. After suffering partial paralysis and then undergoing nerve transfer surgery, they regained movement in their arms.
Wolfe said he and his colleagues published their work to raise awareness in the medical community.
In 2014, Wolfe performed the first successful nerve transfer on an AFM patient afflicted with enterovirus EV-D68 respiratory illness. Enteroviruses are a group of common infections that affect children.
Wolfe performed several nerve transfer surgeries for EV-D68 during an outbreak in 2014. Since then, he’s done several dozen nerve transfer surgeries for a variety of conditions.
“The procedure is delicate and meticulous,” he said. “To prepare, my colleagues and I conduct exhaustive planning and hours of muscle and nerve testing. Each set of nerve transfers is performed under a microscope and can take five to seven hours.”