Woman regains movement and function in leg after rare nerve transfer surgery at Jackson
By: Krysten Brenlla
For Carrie Bloemers, 34, staying active was always a part of her daily life.
“I especially loved running,” Bloemers said. “It was my passion.”
However, her running days were cut short when she started to experience extreme pain in her right knee and hip after giving birth to her third baby in May 2020.
“I started going to physical therapy for the pain, and my physical therapist felt a lump in my abdomen, around my right hip,” Bloemers said. “That’s when I found out I was growing a tumor.”
On January 13, 2021, she underwent surgery at a hospital on the west coast of Florida to remove the mass.
However, in the midst of the procedure, her surgeons discovered the tumor was vascular. It intertwined with her femoral nerve, which controls the movement and sensation in the hips and legs. To remove the tumor, her surgeons also had to remove the nerve, causing Bloemers to lose all function in her right quadriceps, or the front muscle on her right thigh.
As a result, the entire front side of her leg went numb.
“I had to relearn how to get around with a walker and knee brace. I built my strength back up to just use a cane, but I couldn’t walk without an assistive device,” Bloemers said. “It was extremely difficult to go from being active every day to bedridden.”
After she was discharged from the hospital, Bloemers required rehabilitation therapy. She was told she would probably never regain her muscle function again.
Facing the possibility of never being able to run again, or walk without a cane or knee brace, Bloemers was determined to find a solution.
Fortunately, she found hope when she met Allan D. Levi, MD, PhD, chief of neurosurgery at Jackson Memorial Hospital.
“When we first saw Caroline six months after her initial surgery, she still needed a cane and knee brace. She was pretty disabled,” Dr. Levi said. “To repair the nerve directly; if there’s a nerve gap, we typically fill the nerve gap with grafts to allow regeneration to occur. But, Caroline’s gap was so big and close to the spine, and far from her target muscle, that we knew we had to try something different.”
Dr. Levi and the Jackson Memorial neurosurgery team decided a nerve transfer surgery to Bloemers’ right quadriceps muscle was the best option for her – a rare surgical technique that transfers a nerve from another muscle to the affected muscle, in hopes that the muscle will regain function in the future.
On June 4, 2021, Dr. Levi and his surgical team successfully transferred a part of her obturator nerve, the nerve that provides muscle movement and sensation to the inner thigh, to the nerve supplying the right quadriceps muscle on Bloemers.
“I was dreading going through a second surgery, but when I woke up afterward, I felt hopeful,” Bloemers said. “I knew that my second surgery was going to change my life.”
For 16 months after her nerve transfer, Bloemers continued to use a walker and knee brace to get around, as the nerve took time to regenerate. She also needed to train her brain to reactivate the nerve specifically for the affected muscle.
“At first, everything felt like a setback – I couldn’t even carry my toddler out of daycare,” Bloemers said. “For almost a year after my second surgery, I focused on activating that small trail of nerve that we knew had made it to the paralyzed muscle.”
However, by March 2022, she and her doctors picked up her first quadriceps muscle signal.
To train, Bloemers used a yoga ball in between her knees to reprogram the nerve and muscle pathway. She moved her legs laterally to train her brain to activate the quadriceps muscle with the new nerve.
Despite the challenges, just 18 months after the nerve transfer, Bloemers’ muscles were strong enough that she started stationary cycling. By April 2023, she hit a major milestone – she was able to kick her foot out when sitting on a chair, a small action that was impossible for her to do beforehand.
“It was a lot of hard work and determination to get to this point,” she said.
Today, Bloemers can walk normally on her own, climb up and down stairs, and is able to keep up with her family. Her goal is to continue cycling and building her muscle strength, so she can regain the active lifestyle that she loved.
She is eternally grateful to the teams at Jackson for their innovation, ultimately leading to her new and improved life.
“This was a very unique procedure, and they went after it with my own goals in mind. Without this team, I wouldn’t be where I’m at today,” Bloemers said.
“They’ve given me a lot of my life back.”