Extradural implantation of sacral anterior root stimulators

Journal ofNeurology, Neurosurgery and Psychiatry, 1990 · DOI: · Published: August 1, 1990

Simple Explanation

This paper describes a surgical technique for implanting sacral anterior root stimulators extradurally to help patients with spinal cord lesions regain bladder control. The procedure involves deafferentation of the S2 to S5 segments and implantation of stimulating electrodes outside the dura mater. The extradural approach is compared to the more common intrathecal method, discussing the advantages and disadvantages of each.

Study Duration

Not specified

Participants

Twelve patients with spinal cord lesions

Evidence Level

Not specified

Key Findings

1
Nine out of twelve patients with spinal cord lesions were able to use their implants for micturition.
2
Seven patients achieved full continence using the extradural sacral anterior root stimulators.
3
Some anterior root damage was found in all 12 patients with extradural implantation.

Research Summary

The paper introduces a technique for extradural implantation of sacral anterior root stimulators as an alternative to the intrathecal approach for bladder control in patients with spinal cord lesions. The study reports on twelve patients who underwent the extradural procedure, highlighting improvements in micturition and continence. The authors discuss the benefits and drawbacks of the extradural technique compared to the intrathecal method, considering factors such as surgical time, risk of spinal deformity, CSF leakage, deafferentation completeness and anterior root damage.

Practical Implications

Alternative Surgical Approach

Provides a viable alternative to the intrathecal approach for patients with spinal cord lesions who require sacral anterior root stimulators.

Reduced Risk of CSF Leakage

The extradural procedure minimizes the risk of cerebrospinal fluid leakage compared to intrathecal implantation.

Improved Bladder Control

Offers the potential for improved micturition and continence in patients with spinal cord lesions, enhancing their quality of life.

Study Limitations

1
Higher risk of anterior root damage compared to the intrathecal procedure.
2
Potential for incomplete deafferentation due to connective tissue binding.
3
The small sample size (12 patients) limits the generalizability of the findings.

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