FUNCTIONAL RECONSTRUCTION OF DEFECATION AND URINARY FUNCTIONS IN PARAPLEGIC PATIENTS BY VASCULARIZED INTERCOSTAL NERVES TRANSFER TO SACRAL NERVE ROOTS WITH SELECTED INTERFASCICULAR ANASTOMOSIS
- VernacularTitle:带血管肋间神经移位与骶神经根选择性束间吻接行截瘫大小便功能重建
- Author:
Shaocheng ZHANG
;
Yuhai MA
;
Zhenwei ZHANG
- Publication Type:Journal Article
- Keywords:
paraplegia;
nerve transfer;
recovery of function;
fecal and urinary functions
- From:
Medical Journal of Chinese People's Liberation Army
2001;0(09):-
- CountryChina
- Language:Chinese
-
Abstract:
The aim of this procedure is to reconstruct the defecation and urinary functions in paraplegic patients. In 30 patients, two normal vascularized intercoastal nerves above the paraplegic level were isolated and their distal ends divided. They were transferred to the vertebral canal through a submuscular tunnel. The sural nerve was harvested with enough length and separated into two segments, which were sutured as a bridge with S 2-4 nerve roots by interfascicular neurorrhaphy in patients with spinal cord injury above T 11 or with S 2-4 nerve roots outside of the vertebral canal in patients with spinal cord injury below T 12. After 2 to 11-year (mean 5 years) follow-up, 26 (86.6%) patients regained partial micturition reflex and defecation reflex, and partial sensation (S1-2) in buttock, perineal and vulva regions. In 23 (76.7%) patients had also recovery of the function of voluntary urination, and 8 (27%) of them showed partial recovery of function of the detrusor muscle, urethral sphincter, and anal sphincter. The results showed that the procedure described above could be used as an alternative method to reconstruct the function of defecation and urination, and also partial sensation of perineal and vulval region in a part of paraplegic patients.
