Sacral anterior root stimulators for bladder control in paraplegia: the first 50 cases.

Brindley, G. S.; Polkey, Charles E.; Rushton, D. N.; Cardozo, Linda

doi:10.1136/jnnp.49.10.1104

Cited by 295 publications

(167 citation statements)

References 11 publications

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“…Similarly, Brindley et al induced erection in 26 of 38 patients by neurostimulation of different anterior sacral roots. 8 The activation of the sympathetic fibers does not seem to have an important role, since sympathetic stimulation alone inhibits penile erection. 1011 Our findings strongly support the hypothesis that cavernous electrical activity is modulated by the sympathetic and the parasympathetic systems.…”

Section: Discussionmentioning

confidence: 99%

“…For treatment of bladder spasticity in all patients, sacral deafferentation (dorsal rhizotomy) was done at the level of S2 to S5 ( fig. 1) and platinum foil electrodes for neurostimulation were placed around the anterior roots of S2 to S5 in "books" (that is U-shaped electrodes mounted in slots 8 ). In all patients complete bladder emptying, bowel evac uation and penile erection could be achieved by different neuro stimulation patterns.…”

Section: Methodsmentioning

confidence: 99%

“…Around the anterior roots of S2 to S5 electrodes for neurostimulation were placed. Cavernous electrical activity was recorded with an intracavernous needle electrode and with surface electrodes in the flaccid as well as in the erect states induced by neurostimulation (at 7,8,12,18,20,30 and 45 Hz.,30 v. and 0.4 msec). In all patients similar potentials compared to the normal values, as well as additional pathological potentials were recorded during flaccidity.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Influence of Anterior Root Stimulation (S2) in Deafferented Spinal Cord Injury Men on Cavernous Electrical Activity

et al. 1992

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Influence of Anterior Root Stimulation (S2) in Deafferented Spinal Cord Injury Men on Cavernous Electrical Activity

et al. 1992

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“…11 We here describe the state of these first 50 patients. Two have died, both from causes unrelated to the urinary tract.…”

mentioning

confidence: 99%

Long-term follow-up of patients with sacral anterior root stimulator implants

Brindley¹,

Rushton²

1990

Spinal Cord

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110

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SummaryThe first 50 patients to receive a sacral anterior root stimulator for bladder control were reviewed by questionnaire in mid-1989. At that time, the follow-up period varied from 5 to 11 years, and 48 of the group were alive; 2 had died from unrelated causes. Forty-one used their implants regularly for micturition and of these, 37 were always or usually continent. Twenty-nine reported no symptomatic urinary infections in the previous year, and only 4 had 3 infections or more. Twenty-seven used their implant to assist defaeca tion, and 13 of 32 male users reported full implant-driven erections.Side effects are minor, except for stimulus evoked pain sensation, which prevents use of the implant in 3 of the 7 non-users. Two of the other non-users were awaiting repair of their implant faults.

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“…Over the past three decades, considerable technological development has greatly improved the ability of functional electrical stimulation (FES) to restore movement following spinal cord injury (SCI), including upper 1 ± 3 and lower 3 ± 5 extremity movement, bladder and bowel function 6,7 and respiratory capacity. 8,9 Successful application of any FES system requires that the lower motor neuron (LMN) and muscle ®bers it supplies are intact and capable of responding to stimulus pulses of short duration.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the lower motor neuron integrity of upper extremity muscles in high level spinal cord injury

Mulcahey

1999

Spinal Cord

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Purpose: To evaluate the lower motor neuron (LMN) integrity of upper extremity muscles of persons with high tetraplegia (C1-C4) in order to determine muscles available for stimulation. Methods: Fourteen subjects (23 arms) were evaluated for LMN integrity. Muscles that elicited a functional response (grade 3 or better) to surface electrical stimulation were considered to have intact LMN and good candidates for FES. Strength-duration (S-D) curves were generated on muscles that showed weak (less than grade 3) or no response to surface stimulation. Muscles were considered denervated if S-D curves were discontinuous or depicted steep, increasing amplitude for pulse durations greater than 1 m. Results: Muscles for grasp and release had intact LMN in 19 of 23 (83%) arms. The wrist extensors and¯exors and pronator were excitable in 17 (74%), 20 (87%) and 19 (83%) arms, respectively. The supinator demonstrated LMN lesion in 80% of the arms. Over 90% of the biceps muscles were unresponsive to electrical stimulation and 85% and 87% of the deltoid and supraspinatus muscles, respectively, were not electrically excitable. The latissimus dorsi and triceps muscles were typically innervated (78% and 91%, respectively) and slightly more than half (52%) of the pectoralis major muscles were excitable. Conclusion: These data suggest that application of FES in high tetraplegia for hand and arm function would require augmentation because of the inability to stimulate the elbow¯exors, deltoid and rotator cu muscles. These data also show that several paralyzed proximal muscles with intact LMN that have been historically transferred to address shoulder paralysis in other patient populations are available for transfer and stimulation in the population with high level spinal injuries.

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Sacral anterior root stimulators for bladder control in paraplegia: the first 50 cases.

Cited by 295 publications

References 11 publications

The Influence of Anterior Root Stimulation (S2) in Deafferented Spinal Cord Injury Men on Cavernous Electrical Activity

The Influence of Anterior Root Stimulation (S2) in Deafferented Spinal Cord Injury Men on Cavernous Electrical Activity

Long-term follow-up of patients with sacral anterior root stimulator implants

Evaluation of the lower motor neuron integrity of upper extremity muscles in high level spinal cord injury

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