反射性膀胱に対する選択的仙髄神経根切断術

Abstract

Selective sacral rhizotomy was applied to a forty-year-old female patient suffering from marked reflex bladder due to spinal cord injury. Cauda equina was approached by laminectomy from the fifth lumbar to the second sacral lamina. Nerves bringing contraction of the bladder were easily indentified by electrical stimulation and. divided. After this procedure complete relaxation of the bladder was acquired but difficult urination due to spasms of the external vesical sphincter lasted twenty-eight days after the operation. This sphincter spasm was studied by electromyography. After one hundred days, her urination became smooth and she had no residual urine. No sphincter spasm was seen by electromyography at this time. This procedure should be preferably applied to the patient without marked spasticity of the lower extremities because this procedure is not destructive against other sacral nerves.