Outcomes of lumbar to sacral nerve rerouting for spina bifida

The Journal of Urology
Kenneth M PetersAnanias Diokno

Abstract

Restoring bladder and bowel function in spina bifida by creation of a skin-central nervous system-bladder reflex arc via lumbar to sacral nerve rerouting has a reported success rate of 87% in China. We report 1-year results of the first North American trial on nerve rerouting. Nine subjects were enrolled in the study. Intradural lumbar to sacral nerve rerouting was performed. Subjects underwent urodynamic testing with stimulation of the cutaneous dermatome and careful neurological followup. Adverse events were closely monitored along with changes in bowel and bladder function. At 1 year 7 patients (78%) had a reproducible increase in bladder pressure with stimulation of the dermatome. Two patients were able to stop catheterization and all safely stopped antimuscarinics. No patient achieved complete urinary continence. The majority of subjects reported improved bowel function. One patient was continent of stool at baseline and 4 were continent at 1 year. Of the patients 89% had variable weakness of lower extremity muscle groups at 1 month. One child had persistent foot drop and the remainder returned to baseline by 12 months. At 1 year a novel reflex arc with stimulation of the appropriate dermatome was seen in the majority of s...Continue Reading

Citations

Nov 1, 2011·Current Urology Reports·Gregory E Dean, Christopher Long
Jul 9, 2013·Current Urology Reports·Sumit Dave, Joao Luiz Pippi Salle
Oct 1, 2010·Nature·David Cyranoski
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May 4, 2016·Journal of Neurosurgery. Pediatrics·Andrew Jea
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Oct 4, 2021·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Ximing XuJiangang Shi

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