New strategies of pelvic nerves stimulation for recovery of pelvic visceral functions and locomotion in paraplegics.

Details

Serval ID
serval:BIB_53296D90F81D
Type
Article: article from journal or magazin.
Collection
Publications
Title
New strategies of pelvic nerves stimulation for recovery of pelvic visceral functions and locomotion in paraplegics.
Journal
Neurourology and Urodynamics
Author(s)
Possover M., Schurch B., Henle K.P.
ISSN
1520-6777 (Electronic)
ISSN-L
0733-2467
Publication state
Published
Issued date
2010
Volume
29
Number
8
Pages
1433-1438
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Abstract
AIMS: To present new strategies of pelvic nerves stimulation to enhance micturition, to control spasticity, and to recover locomotion in paraplegics.
METHODS: Three consecutive patients-Th5, Th7, and Th10 spinal cord injured-underwent laparoscopic transperitoneal implantation of octipolar electrodes to the sciatic and the pudendal nerves and one double extradural Brindley-Finetech electrode bilaterally to the sacral nerve roots S3 and S4. The two octipolar electrodes were connected to an implanted rechargeable generator, while the double Brindley electrode was connected to an implanted Brindley-Finetech receiver block.
RESULTS: Continuous stimulation of the sciatic and pudendal nerves at a frequency of 20 Hz in all three patients permits complete control of the spasticity of the lower extremities and of reflex incontinence. Bladder emptying is obtained by sacral nerve roots stimulation alone in the first patient, by simple interruption of pudendal stimulation in the second ("pudendal-deblockade") and by simultaneous sacral nerve roots stimulation with high-frequency pudendal nerve blockade in the third patient. Functional electrical stimulation of the femoral nerves enables the Th4 paraplegics lower-limb cycling and the two further patients standing and alternative locomotion.
CONCLUSION: This short series indicated that laparoscopic implantation of neuroprothesis to the pelvic nerves offers absolutely new strategies based on new combinations of various reported methods to enhance bladder functions and to recover some locomotion in paraplegics.
Keywords
Electric Stimulation Therapy/instrumentation, Electrodes, Implanted, Female, Femoral Nerve/physiopathology, Humans, Laparoscopy, Locomotion, Lower Extremity/innervation, Male, Paraplegia/complications, Paraplegia/physiopathology, Penile Erection, Sciatic Nerve/physiopathology, Treatment Outcome, Urinary Bladder/innervation, Urinary Bladder, Overactive/etiology, Urinary Bladder, Overactive/physiopathology, Urinary Incontinence/etiology, Urinary Incontinence/physiopathology, Urination
Pubmed
Web of science
Create date
05/11/2014 12:13
Last modification date
20/08/2019 14:08
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