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...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.展开更多
The sacral nerve anterior root consists of parasympathetic nerves（dominating urinary bladder detrusor）and somatic motor nerves（dominating urethral sphincter）,and electrical stimulation to the sacral nerve anterior...The sacral nerve anterior root consists of parasympathetic nerves（dominating urinary bladder detrusor）and somatic motor nerves（dominating urethral sphincter）,and electrical stimulation to the sacral nerve anterior root induces simultaneous contraction of the bladder detrusor and urethral sphincter.Accordingly,urethral pressure exceeds intravesical pressure,resulting in little or no urination,kidney damage,and trembling of lower limbs due to high intravesical pressure.In the present study,sacral nerve posterior roots were transected in a spastic bladder rabbit model,followed by three-pole electrode and long-pulse electrical stimulation to the sacral anterior root.Intravesical and urethral pressures were simultaneously measured to verify the feasibility of anode inhibition to the sacral anterior root following induced detrusor contraction.As stimulus intensity increased,somatic motor nerves were increasingly inhibited; with a stimulus pulse width of 300 μs and stimulus current of 1.05 mA,urethral pressure was zero and average intravesical pressure was 3.84 kPa.In addition,detrusor contraction was displayed,and lower extremity trembling was significantly reduced.Three-pole electrode and long-pulse electrical stimulation to the sacral nerve anterior root induced detrusor contraction and inhibited low extremity trembling under electrical stimulation.展开更多
Previous studies have shown that, anode block electrical stimulation of the sacral nerve root can produce physiological urination and reconstruct urinary bladder function in rabbits. However, whether long-term anode b...Previous studies have shown that, anode block electrical stimulation of the sacral nerve root can produce physiological urination and reconstruct urinary bladder function in rabbits. However, whether long-term anode block electrical stimulation causes damage to the sacral nerve root re- mains unclear, and needs further investigation. In this study, a complete spinal cord injury model was established in New Zealand white rabbits through T9_10 segment transection. Rabbits were given continuous electrical stimulation for a short period and then chronic stimulation for a longer period. Results showed that compared with normal rabbits, the structure of nerve cells in the anterior sacral nerve roots was unchanged in spinal cord injury rabbits after electrical stimu- lation. There was no significant difference in the expression of apoptosis-related proteins such as Bax, Caspase-3, and Bcl-2. Experimental findings indicate that neurons in the rabbit sacral nerve roots tolerate electrical stimulation, even after long-term anode block electrical stimulation.展开更多
Some pelvic pain syndromes are very resistant to medical treatment. Several studies have demonstrated that sacral neuromodulation, which has been successfully used for the treatment of bladder dysfunction, incontinenc...Some pelvic pain syndromes are very resistant to medical treatment. Several studies have demonstrated that sacral neuromodulation, which has been successfully used for the treatment of bladder dysfunction, incontinence, urinary retention and urinary frequency [1]-[3], can be successfully used for the treatment of chronic pelvic pain [4]-[7]. Several studies have also demonstrated significant involvement of dorsal column pathways in the transmission of visceral pelvic pain [8] and the successful use of spinal cord stimulation for the treatment of chronic pelvic pain [9]. We report three cases of severe chronic pelvic pain that failed conservative treatment modalities. Placement of a combined sacral nerve roots stimulator and a low thoracic spinal cord stimulator resulted in a significant pain relief and improvement in daily life activities. We believe that this combination may help patients suffering from chronic pelvic pain resistant to medical management.展开更多
Objective To summarize the anesthesia techniques performed in the selective posterior rhizotomy(SPR) at lumbar and sacral regions(L&R)on juvenile cerebral palsy(CP) patients. Method 144 CP patients below 10 years ...Objective To summarize the anesthesia techniques performed in the selective posterior rhizotomy(SPR) at lumbar and sacral regions(L&R)on juvenile cerebral palsy(CP) patients. Method 144 CP patients below 10 years were successfully performed SPR at L&R under combined intravenous and inhalation anesthesia (CIIA) in prone position with threshold values of each nerve root being measured by means of nerve root electric stimulus (NRES). Result All patients were performed SPR and NRES successfully although blood pressure and heart rate increased significantly while NRES. Conclusion CIIA is safe and effective for juvenile CP patients to be performed SPR at L&R.展开更多
基金Supported by the National Science Fundation of China, No. 30440058
文摘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.
基金a grant for International Cooperation Project by Jilin Provincial Science and Technology Commission,No.20100735
文摘The sacral nerve anterior root consists of parasympathetic nerves（dominating urinary bladder detrusor）and somatic motor nerves（dominating urethral sphincter）,and electrical stimulation to the sacral nerve anterior root induces simultaneous contraction of the bladder detrusor and urethral sphincter.Accordingly,urethral pressure exceeds intravesical pressure,resulting in little or no urination,kidney damage,and trembling of lower limbs due to high intravesical pressure.In the present study,sacral nerve posterior roots were transected in a spastic bladder rabbit model,followed by three-pole electrode and long-pulse electrical stimulation to the sacral anterior root.Intravesical and urethral pressures were simultaneously measured to verify the feasibility of anode inhibition to the sacral anterior root following induced detrusor contraction.As stimulus intensity increased,somatic motor nerves were increasingly inhibited; with a stimulus pulse width of 300 μs and stimulus current of 1.05 mA,urethral pressure was zero and average intravesical pressure was 3.84 kPa.In addition,detrusor contraction was displayed,and lower extremity trembling was significantly reduced.Three-pole electrode and long-pulse electrical stimulation to the sacral nerve anterior root induced detrusor contraction and inhibited low extremity trembling under electrical stimulation.
基金supported by the International Cooperation Projects of Jilin Province Science and Technology Commission,No.20100735
文摘Previous studies have shown that, anode block electrical stimulation of the sacral nerve root can produce physiological urination and reconstruct urinary bladder function in rabbits. However, whether long-term anode block electrical stimulation causes damage to the sacral nerve root re- mains unclear, and needs further investigation. In this study, a complete spinal cord injury model was established in New Zealand white rabbits through T9_10 segment transection. Rabbits were given continuous electrical stimulation for a short period and then chronic stimulation for a longer period. Results showed that compared with normal rabbits, the structure of nerve cells in the anterior sacral nerve roots was unchanged in spinal cord injury rabbits after electrical stimu- lation. There was no significant difference in the expression of apoptosis-related proteins such as Bax, Caspase-3, and Bcl-2. Experimental findings indicate that neurons in the rabbit sacral nerve roots tolerate electrical stimulation, even after long-term anode block electrical stimulation.
文摘Some pelvic pain syndromes are very resistant to medical treatment. Several studies have demonstrated that sacral neuromodulation, which has been successfully used for the treatment of bladder dysfunction, incontinence, urinary retention and urinary frequency [1]-[3], can be successfully used for the treatment of chronic pelvic pain [4]-[7]. Several studies have also demonstrated significant involvement of dorsal column pathways in the transmission of visceral pelvic pain [8] and the successful use of spinal cord stimulation for the treatment of chronic pelvic pain [9]. We report three cases of severe chronic pelvic pain that failed conservative treatment modalities. Placement of a combined sacral nerve roots stimulator and a low thoracic spinal cord stimulator resulted in a significant pain relief and improvement in daily life activities. We believe that this combination may help patients suffering from chronic pelvic pain resistant to medical management.
文摘Objective To summarize the anesthesia techniques performed in the selective posterior rhizotomy(SPR) at lumbar and sacral regions(L&R)on juvenile cerebral palsy(CP) patients. Method 144 CP patients below 10 years were successfully performed SPR at L&R under combined intravenous and inhalation anesthesia (CIIA) in prone position with threshold values of each nerve root being measured by means of nerve root electric stimulus (NRES). Result All patients were performed SPR and NRES successfully although blood pressure and heart rate increased significantly while NRES. Conclusion CIIA is safe and effective for juvenile CP patients to be performed SPR at L&R.
