Spinal cord stimulation for the restoration of bladder function after spinal cord injury

Healthcare Technology Letters

article

Casey J. Steadman¹  Warren M. Grill¹ 

[1] Department of Biomedical Engineering, Duke University;Department of Electrical and Computer Engineering, Duke University;Department of Neurobiology, Duke University;Department of Neurosurgery, Duke University

关键词: bioelectric phenomena;    biomedical electrodes;    patient treatment;    injuries;    neurophysiology;    diseases;    concomitant activity-based training;    anticholinergic medication;    detrusor sphincter dyssynergia;    neurogenic detrusor overactivity;    self-catheterisation;    bladder capacity;    bladder dysfunction;    spinal cord injury;    SCS-mediated restoration;    effective stimulation parameters;    spinal cord stimulation;    SCI;    bladder function;   

DOI  :  10.1049/htl.2020.0026

学科分类：肠胃与肝脏病学

来源: Wiley

【 摘 要 】

Spinal cord injury (SCI) results in the inability to empty the bladder voluntarily, and neurogenic detrusor overactivity (NDO) and detrusor sphincter dyssynergia (DSD) negatively impact both the health and quality of life of persons with SCI. Current approaches to treat bladder dysfunction in persons with SCI, including self-catheterisation and anticholinergic medications, are inadequate, and novel approaches are required to restore continence with increased bladder capacity, as well as to provide predictable and efficient on-demand voiding. Improvements in bladder function following SCI have been documented using a number of different modalities of spinal cord stimulation (SCS) in both persons with SCI and animal models, including SCS alone or SCS with concomitant activity-based training. Improvements include increased volitional voiding, voided volumes, bladder capacity, and quality of life, as well as decreases in NDO and DSD. Further, SCS is a well-developed therapy for chronic pain, and existing Food And Drug Administration (FDA)-approved devices provide a clear pathway to sustainable commercial availability and impact. However, the effective stimulation parameters and the appropriate timing and location of stimulation for SCS-mediated restoration of bladder function require further study, and studies are needed to determine underlying mechanisms of action.

【 授权许可】

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