Sacral anterior root stimulated defecation in spinal cord injuries: An experimental study in canine model

World J Gastroenterol, 2005 · DOI: · Published: March 21, 2005

Spinal Cord Injury Neurology Gastroenterology

Simple Explanation

Spinal cord injuries often lead to impaired pelvic organ functions, including bowel dysfunction. While urinary problems have seen improvements, bowel disorder management has remained relatively unchanged. The study investigates the potential of using sacral anterior root stimulation to induce defecation in individuals with spinal cord injuries, similar to how it's used for bladder emptying. Electrodes were implanted on bilateral S2 roots in dogs, and the results showed that stimulation of these roots contributed to good micturition and defecation.

Study Duration

17-41 d

Participants

11 spinal cord injured mongrel dogs

Evidence Level

Not specified

Key Findings

1
S2 root is the most dominant contributor to rectal pressure in dogs, according to the study.
2
S3 root was the most dominant contributor to sphincter pressure.
3
Stimulation of bilateral S2 with implanted electrodes contributes to good micturition and defecation in dogs.

Research Summary

The study aimed to investigate the dominant sacral root for rectum and anal sphincter motive function to provide a basis for sacral root electrically stimulated defecation in spinal cord injuries. Eleven spinal cord injured dogs were studied using electrostimulation of L7-S3 roots and recording rectal and sphincter pressures. Four animals received S2 root implants. The study concludes that the S2 root is the most dominant contributor to rectal pressure in dogs and that stimulation of bilateral S2 roots leads to good micturition and defecation.

Practical Implications

Neuroprosthetic device for bowel management

The findings suggest the potential use of neuroprosthetic devices to manage bowel dysfunction in spinal cord injury patients, reducing the need for traditional methods like laxatives.

Selective sacral root stimulation

The study highlights the importance of selective sacral root stimulation (specifically S2) for achieving controlled rectal evacuation and micturition.

Post-stimulus defecation

The research elucidates the mechanism of 'post-stimulus defecation,' which takes advantage of the biomechanical differences between smooth and striated muscles to achieve effective bowel emptying.

Study Limitations

1
The study was conducted on a canine model, and results may not directly translate to humans.
2
The sample size of implanted animals (n=4) is relatively small.
3
The study duration post-implantation was limited to an average of 23 days.

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