Human spinal cord injury: new and emerging approaches to treatment

Johnston, Laurance

doi:10.1038/sj.sc.3101220

Cited by 13 publications

(5 citation statements)

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“…6,7,20,27,30 There are several recent reports of successful somatic nerve transfers in animal models and in patients for restoration of bladder function. 3,4,9,10,14,19-22,26,31 We found, using a canine model, that bladder reinnervation after sacral ventral root transection can be achieved by nerve transfer and surgical coaptation of coccygeal roots to the severed sacral roots, or transfer of genitofemoral nerves to the pelvic nerve as evidenced by increased bladder pressure upon functional electrical stimulation of these nerves after time had elapsed for reinnervation. In the majority of animals in each group, effective detrusor contractions were elicited with stimulation of the reinnervated pelvic nerve.…”

Section: Introductionmentioning

confidence: 85%

Anatomical feasibility of performing a nerve transfer from the femoral branch to bilateral pelvic nerves in a cadaver: a potential method to restore bladder function following proximal spinal cord injury

Brown¹,

Barbe

Albo

et al. 2013

SPI

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Object Nerve transfers are an effective means of restoring control to paralyzed somatic muscle groups and have recently been shown to be effective in denervated detrusor muscle in a canine model. A cadaveric study was performed to examine the anatomical feasibility of transferring femoral muscular nerve branches to vesical branches of the pelvic nerve as a method of potentially restoring innervation to control the detrusor muscle in humans. Methods Twenty cadavers were dissected bilaterally to expose pelvic and femoral muscular nerve branches. Ease of access and ability to transfer the nerves were assessed, as were nerve cross-sectional areas. Results The pelvic nerve was accessed at the base of the bladder, inferior to the ureter, and accompanied by inferior vesical vessels. Muscular branches of the femoral nerve to the vastus medialis and intermedius muscles (L-3 and L-4 origins) were followed distally for 17.4 ± 0.8 cm. Two muscle branches were split from the femoral nerve trunk, and tunneled inferior to the inguinal ligament. One branch was moved medially toward the base of the bladder and linked to the ipsilateral pelvic nerve. The second branch was tunneled superior to the bladder and linked to the contralateral pelvic nerve. The cross-sectional area of the pelvic nerve vesical branch was 2.60 ± 0.169 mm2 (mean ± SEM), and the femoral nerve branch at the suggested transection site was 4.40 ± 0.41 mm2. Conclusions Use of femoral nerve muscular branches from the vastus medialis and intermedius muscles for heterotopic nerve transfer of bilateral pelvic nerves is surgically feasible, based on anatomical location and cross-sectional areas.

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Section: Introductionmentioning

confidence: 85%

Anatomical feasibility of performing a nerve transfer from the femoral branch to bilateral pelvic nerves in a cadaver: a potential method to restore bladder function following proximal spinal cord injury

Brown¹,

Barbe

Albo

et al. 2013

SPI

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“…4,5,9,14,21,23,24 There are recent reports of successful somatic nerve transfers, in animal models and in patients, for restoration of bladder function. 8,10,13,15–17,24,25 Using a canine model, we have shown that bladder reinnervation after sacral ventral root transection can be achieved through nerve transfer and surgical coaptation of coccygeal roots to the severed sacral roots, or transfer of the genitofemoral nerve to the pelvic nerve, as evidenced by increased bladder pressure on functional electrical stimulation. 15–17 Effective detrusor contractions were elicited with stimulation of the reinnervated pelvic nerve.…”

mentioning

confidence: 98%

Feasibility of a femoral nerve motor branch for transfer to the pudendal nerve for restoring continence: a cadaveric study

Barbe

Brown

Pontari

et al. 2011

SPI

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Object Nerve transfers are an effective means of restoring control to paralyzed somatic muscle groups and, recently, even denervated detrusor muscle. The authors performed a cadaveric pilot project to examine the feasibility of restoring control to the urethral and anal sphincters using a femoral motor nerve branch to reinnervate the pudendal nerve through a perineal approach. Methods Eleven cadavers were dissected bilaterally to expose the pudendal and femoral nerve branches. Pertinent landmarks and distances that could be used to locate these nerves were assessed and measured, as were nerve cross-sectional areas. Results A long motor branch of the femoral nerve was followed into the distal vastus medialis muscle for a distance of 17.4 ± 0.8 cm, split off from the main femoral nerve trunk, and transferred medially and superiorly to the pudendal nerve in the Alcock canal, a distance of 13.7 ± 0.71 cm. This was performed via a perineal approach. The cross-sectional area of the pudendal nerve was 5.64 ± 0.49 mm2, and the femoral nerve motor branch at the suggested transection site was 4.40 ± 0.41 mm2. Conclusions The use of a femoral nerve motor branch to the vastus medialis muscle for heterotopic nerve transfer to the pudendal nerve is surgically feasible, based on anatomical location and cross-sectional areas.

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“…Therefore, it complements the spinal tissue restructuring. In a paradigm-expanding assumption, we believe that the nerve impulse may be mediated either through a biochemical conduction using neurotransmitters or through electromagnetic channels using a wavelength (1–4,13,14).…”

Section: Resultsmentioning

confidence: 99%

Olfactory Ensheathing Glia Transplantation Combined with LASERPONCTURE® in Human Spinal Cord Injury: Results Measured by Electromyography Monitoring

Bohbot¹

2010

Cell Transplant

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Preliminary results were measured by electromyography monitoring (electromyoscan) on three subjects suffering from spinal cord injury and who underwent a double therapy. The aim of this study was to evaluate regained voluntary activity below the injury in subjects who received a double therapy: 1) an olfactory ensheathing glia (OEG) transplantation using procedures developed by Dr. Hongyun Huang at the Xishan Hospital and Rehabilitation Centre, Beijing, China, and 2) LASERPONCTURE developed by Albert Bohbot, Laboratoire de Recherches sur le LASERPONCTURE, La Chapelle Montlinard, France. Materials uses were the LASERPONCTURE device developed by Albert Bohbot; the PROCOMP5 equipment with softwares BIOGRAPH INFINITI 5 and REHAB SUITE; the sensors MYOSCAN-PRO EMG (SA9401M-50) to record muscle activity, and FLEX/PRO-SA9309M to record skin conductance were fixed on the skin. An infrared laser, whose frequencies and power settings cannot be disclosed due to its proprietary nature, was applied after an OEG injection performed according to Dr. Hongyun Huang's procedures. Three cases, two males and one female, were selected for this study. Presentation and comments of the graphs recordings of voluntary muscle activity below the injury are provided. This preliminary study suggests that the double therapy restores some voluntary muscle activity as measured by electromyography monitoring.

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Human spinal cord injury: new and emerging approaches to treatment

Cited by 13 publications

References 0 publications

Anatomical feasibility of performing a nerve transfer from the femoral branch to bilateral pelvic nerves in a cadaver: a potential method to restore bladder function following proximal spinal cord injury

Anatomical feasibility of performing a nerve transfer from the femoral branch to bilateral pelvic nerves in a cadaver: a potential method to restore bladder function following proximal spinal cord injury

Feasibility of a femoral nerve motor branch for transfer to the pudendal nerve for restoring continence: a cadaveric study

Olfactory Ensheathing Glia Transplantation Combined with LASERPONCTURE® in Human Spinal Cord Injury: Results Measured by Electromyography Monitoring

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