Electrical nerve stimulation to promote micturition in spinal cord injury patients: A review of current attempts

Ren, Jian; Chew, Daniel; Biers, Suzanne; Thiruchelvam, Nikesh

doi:10.1002/nau.22730

Cited by 26 publications

(21 citation statements)

References 37 publications

(50 reference statements)

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“…Although implantation of a SARS in patients with SCI can improve bladder emptying and substantially reduce the incidence of UTIs, it remains uncommonly utilised 7. Reasons for its limited use may include relative physician unfamiliarity with the technique,7 significantly higher costs compared with current medical treatments,20 and significant neurological complications including DSD.…”

Section: Discussionmentioning

confidence: 99%

“…The Finetech-Brindley sacral anterior root stimulator (SARS) was described in 19696 and in retrospective and observational trials is perceived to be an option to improve quality of life and increase independence among those with chronic SCI 7. The device contains three components: (1) an intradural ‘book’ containing four slots each with four electrodes in which anterior nerve roots are trapped; (2) a subcutaneous receiver block connected to the electrodes by silicone-coated cables and (3) an external generator powered by a rechargeable battery.…”

Section: Introductionmentioning

confidence: 99%

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Chronic infection of a Brindley sacral nerve root stimulator

Bramall

Chaudhary

Ahmad³

et al. 2016

BMJ Case Reports

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SUMMARYThe Finetech-Brindley sacral anterior root stimulator (SARS) is implanted for the treatment of bladder dysfunction following spinal cord injury (SCI) and has been successful in improving micturition in many patients with SCI. This case describes a 62-year-old man who presented with a chronic Staphylococcus aureus infection of a Brindley SARS 26 years after implantation following a T5 American Spinal Injury Association A spinal cord injury (T5 ASIA A SCI). He presented with chronic sacral osteomyelitis with a history of periodic implant erosion through the skin. Following a series of interventions, definitive management involved removal of the intradural electrodes and epidural and intradural phlegmon, ligation of the thecal sac and flap reconstruction. In the case of delayed infection of a Brindley SARS, removal of the entire system should be considered, especially if extension of the infection to the intradural compartment is suspected. BACKGROUND

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Chronic infection of a Brindley sacral nerve root stimulator

Bramall

Chaudhary

Ahmad³

et al. 2016

BMJ Case Reports

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“…4). It was possible that the efferent fibers in L6 SN were activated by high current intensities and induced the bladder contraction [14]. …”

Section: Discussionmentioning

confidence: 99%

Electrical Stimulation of the Spinal Dorsal Root Inhibits Reflex Bladder Contraction and External Urethra Sphincter Activity: Is This How Sacral Neuromodulation Works?

Ren

Chew²,

Thiruchelvam³

2016

Urol Int

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Introduction: Using a rat model, we aimed to confirm the inhibitory effect of dorsal spinal root (afferent) stimulation and test if bilateral stimulation is more effective than unilateral stimulation. External urethral sphincter (EUS) electromyography (EMG) is also assessed in conjunction with cystometrogram. Materials and Methods: Eighteen female Sprague-Dawley rats were tested following urethane anesthesia. Via urethral catheterization, the bladder was infused with normal saline to evoke rhythmic bladder reflex contractions (BRC). L6 spinal nerves were isolated and stimulated. Results: L6 stimulation was effective in inhibiting BRC. L6 bilateral dorsal root (DR) stimulation of 50% intensity was required to cause inhibition as compared to unilateral stimulation. In EUS EMG recordings, there was a strong association between EUS EMG activities and bladder contraction. When the bladder contraction was inhibited effectively by L6 DR stimulation, a considerable reduction was also found in the EUS EMG activities. Conclusions: L6 DR stimulation abolished BRC in our rat model. Bilateral L6 DR stimulation produced a 50% reduction in stimulation intensity, providing a similar BRC block. Abolishing BRC also appeared to coincide with a reduction in EUS EMG, implicating that sacral neuromodulation might act centrally, at least rostrally at the T8-9 spinal level.

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“…However, well-designed, randomized and controlled studies are required to evaluate these emerging approaches (Ren et al, 2016). The Wöllner and Lombardi studies specifically describe recommendations to avoid use in incomplete SCI with neurogenic detrusor overactivity (NDO) or chronic retention.…”

Section: Neuromodulationmentioning

confidence: 99%

Translating promising strategies for bowel and bladder management in spinal cord injury

Wheeler

Bowel²,

Groat

et al. 2018

Experimental Neurology

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Loss of control over voiding following spinal cord injury (SCI) impacts autonomy, participation and dignity, and can cause life-threatening complications. The importance of SCI bowel and bladder dysfunction warrants significantly more attention from researchers in the field. To address this gap, key SCI clinicians, researchers, government and private funding organizations met to share knowledge and examine emerging approaches. This report reviews recommendations from this effort to identify and prioritize near-term treatment, investigational and translational approaches to addressing the pressing needs of people with SCI.

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Electrical nerve stimulation to promote micturition in spinal cord injury patients: A review of current attempts

Abstract: Electrical nerve stimulation is a clinical option for promoting micturition in SCI patients. Well-designed, randomized and controlled studies are essential for further investigation.

Cited by 26 publications

References 37 publications

Chronic infection of a Brindley sacral nerve root stimulator

Chronic infection of a Brindley sacral nerve root stimulator

Electrical Stimulation of the Spinal Dorsal Root Inhibits Reflex Bladder Contraction and External Urethra Sphincter Activity: Is This How Sacral Neuromodulation Works?

Translating promising strategies for bowel and bladder management in spinal cord injury

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