Abstract
Study design:
Cross-sectional study.
Objective:
To evaluate the long-term effect of the sacral anterior root stimulator (SARS) on neurogenic bowel dysfunction in a large, well defined spinal cord injury (SCI) cohort.
Setting:
Department of Neuro-Urology, Bad Wildungen, Germany.
Methods:
Subjects undergone surgery at for SARS-SDAF (sacral deafferentation) between September 1986 and July 2011 (n=587) answered a questionnaire. In total, 277 SARS subjects were available for the baseline (recall) and follow-up comparison.
Results:
Median age was 49 years (range: 19–80), time from SCI to surgery was 10 years (range: 0–49) and from surgery to follow-up 13 (range: 1–25). Of the responders 73% used SARS for bowel emptying. On visual analog scale (VAS) ranging from 0–10 (best), satisfaction with SARS was 10. Baseline and follow-up comparison showed a decline in the median VAS score 0–10 (worst) for bowel symptoms from 6 (range: 4–8) to 4 (range: 2–6), P<0.0001; median neurogenic bowel dysfunction score from 17 (range: 11–2) to 11 (range: 9–15), P<0.0001; median St Marks score from 4 (range: 0–7) to 4 (range: 0–5), P=0.01; and median Cleveland constipation score from 7 (range: 6–10) to 6 (range: 4–8), P<0.0001. Use of suppositories, digital evacuation and mini enema and subjects totally dependent on assistance during defecation were significantly lower after SARS.
Conclusions:
The SARS has the potential to be one of the few treatment methods targeting multiple organ dysfunctions following SCI.
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Acknowledgements
The authors thank Professor Soren Laurberg for help and support with the study. Further, we thank the Lundbeck foundation for financial support.
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Rasmussen, M., Kutzenberger, J., Krogh, K. et al. Sacral anterior root stimulation improves bowel function in subjects with spinal cord injury. Spinal Cord 53, 297–301 (2015). https://doi.org/10.1038/sc.2015.2
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DOI: https://doi.org/10.1038/sc.2015.2
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