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Spinal Cord ; 46(1): 70-3, 2008 Jan.
Article in English | MEDLINE | ID: mdl-17420771

ABSTRACT

BACKGROUND: A number of techniques are being investigated to accomplish bladder control recovery in paralyzed patients using the neurostimulation, but currently, all techniques are based on the dorsal implantation of the electrodes using a laminectomy. METHODS: On 27 April 2006 we performed a laparoscopic implantation of a Finetech-Brindley bladder controller on the endopelvic sacral roots in a Th8 completely paralyzed woman who had previously undergone the removal of a Brindley controller due to an arachnoiditis after extrathecal implantation with intradural sacral deafferentation. RESULTS: We required about 3.5 h for the entire surgical procedure; no complications occurred and the patients went home on 5th postoperative day. The patient is now able to void empty her bladder and her rectum using the controller without further need for self-catheterisation. CONCLUSIONS: The presented new technique of laparoscopic implantation of electrodes on the endopelvic portion of the sacral nerve roots is an option to be considered in all paralyzed patients with further wish for electrical induced miction/defecation after previous deafferentation.


Subject(s)
Electric Stimulation Therapy/methods , Laparoscopy/methods , Paraplegia/complications , Spinal Cord Injuries/complications , Spinal Nerve Roots/surgery , Urinary Bladder, Neurogenic/therapy , Defecation , Electrodes, Implanted , Female , Humans , Middle Aged , Neurosurgical Procedures/instrumentation , Neurosurgical Procedures/methods , Paraplegia/physiopathology , Patient Satisfaction , Pelvis/anatomy & histology , Pelvis/surgery , Retroperitoneal Space/anatomy & histology , Retroperitoneal Space/surgery , Sacrum/anatomy & histology , Sacrum/surgery , Spinal Cord Injuries/physiopathology , Spinal Nerve Roots/physiopathology , Treatment Outcome , Urinary Bladder/innervation , Urinary Bladder/physiopathology , Urinary Bladder/surgery , Urinary Bladder, Neurogenic/etiology , Urinary Bladder, Neurogenic/physiopathology , Urination
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