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Abstract
Background:Sacral nerve stimulation is a minimally invasive procedure to treat spinal cord injured (SCI) patients with overactive bladder syndrome or nonobstructive urinary retention that is refractory to conservative treatment.Methods:In this paper, we report a case of traumatic cervical SCI with quadriplegia and spastic bladder, which was managed by third sacral motor branch stimulation in 1998.Results:In this case, stimulation-induced burning of nerve fibers was seen microscopically during the implantation surgery. At 2 weeks after the index surgery, the stimulator was removed due to ineffectiveness. We hypothesize that the stimulation settings of our stimulator were not appropriate for neural stimulation and led to neural destruction, fibrosis, and treatment failure.Conclusion:The device settings of stimulators used in neural stimulation should be appropriate for direct neural stimulation otherwise they can lead to neural destruction and treatment failure.
Highlights
Sacral nerve stimulation is a minimally invasive procedure to treat spinal cord injured (SCI) patients with overactive bladder syndrome or nonobstructive urinary retention that is refractory to conservative treatment
Spinal cord injury (SCI) patients with complete lesions may present with neurogenic bladder dysfunction
The management of lower urinary tract dysfunction still presents a therapeutic challenge despite recent developments
Summary
Sacral nerve stimulation is a minimally invasive procedure to treat spinal cord injured (SCI) patients with overactive bladder syndrome or nonobstructive urinary retention that is refractory to conservative treatment. Spinal cord injury (SCI) patients with complete lesions may present with neurogenic bladder dysfunction. Tanagho and Schmidt[12] demonstrated that continuous stimulation of the sacral root S3 with an electrode and implanted pulse generator could modulate detrusor and sphincter activity and stabilize micturition reflexes.
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