Selective Sacral Rhizotomy for the Management of Neurogenic Bladders in Spina Bifida Patients: Long-Term Followup

Schneidau, T.; Franco, Israel; Zebold, K.; Kaplan, William E.

doi:10.1016/s0022-5347(01)67157-x

Cited by 16 publications

(6 citation statements)

References 6 publications

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“…This procedure had proven effective for other patients and has been described by one of the authors (B.B.S.). 2,7 At the time of selective sacral rhizotomy, the previously performed left L-5 to left S2-3 anastomosis was identified and found to be in anatomical continuity with expected scar tissue surrounding the nerve. Electrical stimulation of the nerve above and below the anastomosis produced no contractions of the bladder as measured by a bladder wall electrode placed through a suprapubic incision.…”

Section: Effect Of Surgery On Bowel and Erectile Functionmentioning

confidence: 99%

Attempted bladder reinnervation and creation of a scratch reflex for bladder emptying through a somatic-to-autonomic intradural anastomosis

Tuite

Storrs

Homsy³

et al. 2013

PED

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An intradural somatic-to-autonomic anastomosis, or Xiao procedure, has been described to create a “skin-CNS-bladder” reflex that improves bladder and bowel function in patients with neurogenic bladder and bowel dysfunction. The authors present their experience with a 10-year-old boy with chronic neurogenic bladder and bowel dysfunction related to spinal cord injury who underwent the Xiao procedure. After undergoing a left L-5 ventral root to left S2–3 intradural anastomosis, the patient reported that his bladder and bowel dysfunction improved between 6 and 12 months. Two years after the procedure, however, he reported that there was no change in his bladder or bowel dysfunction as compared with his condition prior to the procedure. Frequent, systematic multidisciplinary evaluations produced conflicting data. Electrophysiological and histological evaluation of the previously performed anastomosis during surgical reexploration 3 years after the Xiao procedure revealed that the anastomosis was in anatomical continuity but neuroma formation had prevented reinnervation. Nerve action potentials were not demonstrable across the anastomosis, and stimulation of the nerve above and below the anastomosis created no bladder or perineal contractions. This is the first clinical report on the outcome of the Xiao procedure in a child with spinal cord injury outside of China. It is impossible to draw broad conclusions about the efficacy of the procedure based on a single patient with no demonstrable benefit. However, future studies should carefully interpret transient improvements in bladder function, urodynamic findings, and the patient's ability to void in response to scratching after the Xiao procedure. The authors' experience with the featured patient, in whom reinnervation could not be demonstrated, suggests that such changes could be related to factors other than the establishment of a skin-CNS-bladder reflex as a result of a somatic-to-autonomic anastomosis.

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Section: Effect Of Surgery On Bowel and Erectile Functionmentioning

confidence: 99%

Attempted bladder reinnervation and creation of a scratch reflex for bladder emptying through a somatic-to-autonomic intradural anastomosis

Tuite

Storrs

Homsy³

et al. 2013

PED

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“…Sacral rhizotomy, also known as sacral deafferentation (SDAF), has achieved some success in reducing DO (16,(223)(224)(225)(226)(227), but it is used nowadays mostly as an adjuvant to sacral anterior root stimulation (228)(229)(230)(231)(232)(233)(234)(235)(236)(237)(238)(239). Alternatives for rhizotomy are sought in this treatment combination (240)(241)(242).…”

Section: 43mentioning

confidence: 99%

Forty-five-year follow-up on the renal function after spinal cord injury

et al. 2016

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“…On rappellera que, dans ce groupe de patients, la constatation d'une anomalie urodynamique peut faire suspecter la survenue d'un syndrome de moelle attachée. Les résultats urinaires de la correction de la moelle attachée sont sujets à controverse [116][117][118][119][120][121], mais certains auteurs considèrent qu'un suivi régulier pourrait permettre de dépister plus tôt la moelle attachée permettant un traitement plus précoce qui serait plus efficace [120,121].…”

Section: Anomalies Uro-dynamiquesunclassified

Suivi des vessies neurologiques du blessé médullaire et du patient porteur d'une myéloméningocèle Revue de la littérature et recommandations pratiques de suivi

Ruffion¹,

Sèze

Denys

et al. 2006

Pelv Perineol

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L'évolution des patients blessés médullaires (BM) ou porteurs d'une myéloméningocèle (MM) s'est profondément transformée au cours des soixante derniè-res années. Leur espérance de vie s'est considérablement accrue, jusqu'à approcher celle de la population générale. La pathologie urologique reste cependant une des plus grandes pourvoyeuses de morbi-mortalité dans cette population de patients. Dans un premier temps, nous avons souhaité, à travers une revue de la littérature, réactualiser les données épidémiologiques concernant les différentes facettes des pathologies urinaires susceptibles d'être observées chez ces patients. Ce travail s'est accompagné d'une réflexion sur la validité et la pertinence des examens complémentaires proposés dans le diagnostic de ces pathologies. À partir de ces données, nous avons dressé un cahier des charges du suivi neurourologique de ces patients.Mots clés : Vessie neurologique -Blessé médullaire -Myéloméningocèle -Pronostic uronéphrologique Care of neurogenic bladder in spinal cord injured patients and patients with myelomeningocele: Review of the literature and therapeutic recommendationsAbstract: The clinical course of spinal cord injured patients and those with myelomeningocele (MM) has radically changed over the last 60 years. Life expectancy has been significantly extended and is approaching that of the general population. Urologic disease remains, nonetheless, one of the most predictive factors of morbidity and mortality in this patient population. As a first step, we carried out a literature review in an effort to update the epidemiological data concerning the various aspects of urinary disorders observed in these patients. This paper also discusses the validity and appropriateness of additional diagnostic screening procedures for these disorders. Based on this data, we have created clinical guidelines for the neurological and urologic care of these patients.

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Selective Sacral Rhizotomy for the Management of Neurogenic Bladders in Spina Bifida Patients: Long-Term Followup

Cited by 16 publications

References 6 publications

Attempted bladder reinnervation and creation of a scratch reflex for bladder emptying through a somatic-to-autonomic intradural anastomosis

Attempted bladder reinnervation and creation of a scratch reflex for bladder emptying through a somatic-to-autonomic intradural anastomosis

Forty-five-year follow-up on the renal function after spinal cord injury

Suivi des vessies neurologiques du blessé médullaire et du patient porteur d'une myéloméningocèle Revue de la littérature et recommandations pratiques de suivi

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