Effects of highly selective sympathectomy on neurogenic bowel dysfunction in spinal cord injury rats

Scientific Reports, 2021 · DOI: 10.1038/s41598-021-95158-5 · Published: August 12, 2021

Spinal Cord Injury Surgery Gastroenterology

Simple Explanation

Neurogenic bowel dysfunction (NBD) is common after spinal cord injury (SCI). This study explores if removing part of the colon's sympathetic nerve supply can help alleviate hyperreflexic bowel, a type of NBD. The researchers performed peri-arterial sympathectomy of the inferior mesenteric artery (PSIMA) on rats with SCI to cut off sympathetic postganglionic neurons. The study evaluated the impact of PSIMA on bowel habits, stool water content, intestinal function, and colon pressure in the SCI rats. The results suggest that PSIMA can relieve hyperreflexic bowel by reducing sympathetic activity and enhancing parasympathetic regulation of the colon.

Study Duration

12 weeks

Participants

72 Sprague–Dawley rats

Evidence Level

Not specified

Key Findings

1
PSIMA increased the faecal water content of SCI rats by 5–13%.
2
PSIMA increased the emptying rate of the faeces in colon within 24 h by 14–40%.
3
PSIMA increased the defecation pressure of colon by 10–11 mmHg.

Research Summary

This study investigated the effects of peri-arterial sympathectomy of the inferior mesenteric artery (PSIMA) on neurogenic bowel dysfunction (NBD) in spinal cord injury (SCI) rats with hyperreflexic bowel. The results demonstrated that PSIMA increased faecal water content, enhanced colon transmission function, promoted bowel movement, and down-regulated Alpha-2 adrenergic receptors in the distal colon of SCI rats. The findings suggest that PSIMA can improve NBD in SCI rats by reducing sympathetic activity and enhancing parasympathetic regulation of the colon, offering a potential surgical approach for hyperreflexic bowel in SCI patients.

Practical Implications

Potential Clinical Application

PSIMA could potentially be used for hyperreflexic bowel in patients with SCI.

Surgical Method Development

The study suggests a new surgical method that can relieve the severe NBD caused by SCI as a supplement.

Targeted Sympathectomy

PSIMA cutting off sympathetic postganglionic neurons is highly selective and minimally invasive.

Study Limitations

1
The anatomy of the rats’ colon is slightly different from that in human beings.
2
There is species differences in the innervation of colon
3
The potential impacts of PSIMA on gastrointestinal reflex and neurogenic bladder requires further study

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