AnnualReport2020

Nerve Transfers Help ChildrenWho Have AFM Acute flaccid myelitis (AFM), is a neurological condition that can cause the muscles and reflexes in the body to become weak, similar to polio, in some ways. At Shriners Hospitals for Children — Philadelphia, Dan Zlotolow, M.D., and Scott Kozin, M.D., chief of staff, two of the country’s leading upper extremity surgeons, are treating the effects of AFM with nerve transfer surgery. Nerve transfers involve moving a working nerve that has a redundant function to a non-working nerve that has an important function. Nerve transfers have been used to restore function after injuries to the nerves in the arms since the 1920s, and continue to become more refined and sophisticated. The advantages of nerve transfers include the potential to provide increased control of the arm and more muscle recovery than other procedures, such as tendon transfers. Nerve transfer surgery must be performed as early as possible for best results, ideally within six to 12 months from the date of injury, followed by occupational therapy.

other devices, in September 2019, Danika became the first patient of the Philadelphia Shriners Hospital to have VBT surgery post-FDA clearance of the new, procedure- specific technology. If Danika could say anything to her pre-surgery self about the treatment decision, it would be: “It is worth it.” About anterior vertebral body tethering: • 4 50 procedures using the VBT methods and techniques have been completed at the Philadelphia Shriners Hospital since 2011. • A s with all medical care and procedures, results differ based on individual patients. • P atients who opt for the tethering procedure can return to their routine activities, including sports, after about one month. In comparison, after a spinal fusion, it can take six months to a year to reach that point. • T ethering may be an option for adolescent patients with scoliosis for whom wearing a brace is difficult for physical and/or psychosocial reasons.

while maintaining

spinal mobility,” said Dr. Samdani. The new technique makes a powerful

difference for patients. Danika and her parents first came to see Dr. Samdani in August 2018 to discuss options for treating Danika’s scoliosis. As the conversations continued, her spinal curve increased to 41 degrees. Although surgeons at the hospital had completed more than 450 similar procedures using

2019•2020 YEAR IN REVIEW | 43