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See Latest ArticlesClinical outcome of sacral neuromodulation in incomplete spinal cord-injured patients suffering from neurogenic bowel dysfunctions
Spinal Cord, 08/14/09
Lombardi G et al. – Sacral neuromodulation (SNM) therapy should be considered for treatment of chronic neurogenic bowel symptoms (NBS) for select pts with incomplete spinal cord injury (SCI) when conservative treatments fail.
Methods- Retrospective non-blinded study of efficacy and safety of SNM in pts with incomplete SCI with chronic NBS
- Temporary stimulation for NBS for 39 pts with SCI
- Permanent implantation if both NBS improved and Wexner questionnaire scores decreased ≥50% during first stage vs baseline
- Outcome measures: fecal incontinence episodes/wk, evacuations/wk, Wexner score, and Short Form 36 (SF-36) Health Survey questionnaire
- Definitive SNM for 23 SCI pts maintaining clinical benefits after permanent implantation with median 38-mo follow-up
- Length of time since neurologic diagnosis to SNM therapy was the only factor related to implantation success
- In constipation pts (12), median number of evacuations increased 1.65 to 4.98/wk; Wexner score changed from 19.91 to 6.82
- In fecal incontinence pts (11), median number of episodes/wk in final follow-up: 1.32 vs 4.55 pre-SNM
- Consistent statistical improvement on SF-36 for both groups
- No important variation on anorectal manometry vs baseline
- No major complications
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