Sacral anterior root stimulated defecation in spinal cord injuries: An experimental study in canine model

Abstract

AIM: To investigate whether there was a dominant sacral root for the motive function of rectum and anal sphincter, and to provide an experimental basis for sacral root electrically stimulated defecation in spinal cord injuries. METHODS:Eleven spinal cord injured mongrel dogs were included in the study. After L4-L7 laminectomy, the bilateral L7-S3 roots were electrostimulated separately and rectal and sphincter pressure were recorded synchronously. Four animals were implanted electrodes on bilateral S2 roots. RESULTS:For rectal motorial innervation, S2 was the most dominant (mean 15.2 kPa, 37.7% of total pressure), S1 (11.3 kPa, 27.6%) and S3 (10.9 kPa, 26.7%) contributed to a smaller part. For external anal sphincter, S3 (mean 17.2 kPa, 33.7%) was the most dominant, S2 (16.2 kPa, 31.6%) and S1 (14.3 kPa, 27.9%) contributed to a lesser but still a significant part. Above 85% L7 roots provided some functional contribution to rectum and anal sphincter. For both rectum and sphincter, the right sacral roots provided more contribution than the left roots. Postoperatively, the 4 dogs had electrically stimulated defecation and micturition under the control of the neuroprosthetic device.CONCLUSION: S2 root is the most dominant contributor to rectal pressure in dogs. Stimulation of bilateral S2 with implanted electrodes contributes to good micturition and defecation in dogs.

Early sacral neuromodulation prevents urinary incontinence after complete spinal cord injury

“…While the SCI patient‐approved Brindley implant requires necessary bilateral deafferentation of S 2–4 , we investigated, using minimally‐invasive, S 3 ‐bilateral SNM supply without nerve interaction. Whereas others reported only selected success,16, 35–37 one group has previously reported success while applying sacral‐root‐stimulation at the point of injury 12. In a subsequent DSD and detrusor overactivity study, the storage and micturition functions were influenced by parameter revisions 13.…”

Radiographic lumbosacral vertebral abnormalities and constipation in cats

“…Although this study revealed that the lumbar vertebral abnormalities may be related to constipation or megacolon in cats, the association of the abnormal bone location and the affected nerves supplying the colon should be further investigated to clarify the pathogenesis of the large bowel abnormalities. In 2005, Chang et al [35] reported that the innervations of rectal detrusor and external anal sphincter in dogs are provided by the ventral roots of L7, S1, S2, and S3, which originate from the sacral spinal cord parasympathetic and somatic centers. In addition, since large bowel dysfunction, both constipation and megacolon, could be induced by other causes, such as concurrent diseases, dehydration, diet, and other medications, the complete clinical information through physical examination, including multifactorial observation, could provide evidence.…”

Neuroestimulación de raíces sacras para la vejiga neurogénica en lesionados medulares. Criterios de selección

“…4). De manera similar, el programa 2 estimula las raíces S4, produciendo la contracción rectosigmoidea y avanzando las deposiciones hasta la ampolla rectal, facilitando así su extracción mediante digitación anal 15,16 . El programa 3 estimula las raíces S2 y se produce una erección.…”