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The artificial somato-autonomic reflex arch does not improve bowel function in subjects with spinal cord injury

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The artificial somato-autonomic reflex arch does not improve bowel function in subjects with spinal cord injury. / Rasmussen, Mikkel Mylius; Krogh, Klaus; Clemmensen, Dorte; Tankisi, Hatice; Fuglsang-Frederiksen, Anders; Rawashdeh, Yazan F. H.; Bluhme, Henrik; Christensen, Peter.

In: Spinal Cord, Vol. 53, No. 9, 09.2015, p. 705-10.

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@article{1d0bced49fb3466db5bb90e7181d4776,
title = "The artificial somato-autonomic reflex arch does not improve bowel function in subjects with spinal cord injury",
abstract = "Study design: Prospective cohort study.Objective: Although introduced for neurogenic bladder dysfunction, it has been suggested that the artificial somato-autonomic reflex arch alleviates neurogenic bowel dysfunction (NBD). We aimed at evaluating the effects of the reflex arch on NBD.Setting: Denmark.Methods: Ten subjects with supraconal spinal cord injury (SCI) (nine males, median age 46 years) had an anastomosis created between the ventral part of the fifth lumbar or first sacral nerve root and the ventral part of the second sacral nerve root. Standardized assessment of segmental colorectal transit times with radiopaque markers, evaluation of scintigraphic assessed colorectal emptying upon defecation, scintigraphic assessment of colorectal transport during stimulation of the reflex arch, standard anorectal physiology tests and colorectal symptoms were performed at baseline and 18 months after surgery.Results: No significant change was observed in colorectal emptying upon defecation (median 31% of the rectosigmoid at baseline vs 75% at follow-up, P=0.50), no movement of colorectal contents was observed during stimulation of the reflex arch. Segmental colorectal transit times, anal sphincter pressures and rectal capacity did not change, and no change was seen in NBD score (median 13.5 (baseline) vs 12.5 (follow-up), P=0.51), St Marks fecal incontinence score (4.5 vs 5.0, P=0.36) and Cleveland constipation score (6.0 vs 8.0, P=0.75).Conclusions: The artificial somato-autonomic reflex arch has no effect on bowel function in subjects with supraconal SCI.",
author = "Rasmussen, {Mikkel Mylius} and Klaus Krogh and Dorte Clemmensen and Hatice Tankisi and Anders Fuglsang-Frederiksen and Rawashdeh, {Yazan F. H.} and Henrik Bluhme and Peter Christensen",
year = "2015",
month = sep,
doi = "10.1038/sc.2015.75",
language = "English",
volume = "53",
pages = "705--10",
journal = "Spinal Cord",
issn = "1362-4393",
publisher = "Nature Publishing Group",
number = "9",

}

RIS

TY - JOUR

T1 - The artificial somato-autonomic reflex arch does not improve bowel function in subjects with spinal cord injury

AU - Rasmussen, Mikkel Mylius

AU - Krogh, Klaus

AU - Clemmensen, Dorte

AU - Tankisi, Hatice

AU - Fuglsang-Frederiksen, Anders

AU - Rawashdeh, Yazan F. H.

AU - Bluhme, Henrik

AU - Christensen, Peter

PY - 2015/9

Y1 - 2015/9

N2 - Study design: Prospective cohort study.Objective: Although introduced for neurogenic bladder dysfunction, it has been suggested that the artificial somato-autonomic reflex arch alleviates neurogenic bowel dysfunction (NBD). We aimed at evaluating the effects of the reflex arch on NBD.Setting: Denmark.Methods: Ten subjects with supraconal spinal cord injury (SCI) (nine males, median age 46 years) had an anastomosis created between the ventral part of the fifth lumbar or first sacral nerve root and the ventral part of the second sacral nerve root. Standardized assessment of segmental colorectal transit times with radiopaque markers, evaluation of scintigraphic assessed colorectal emptying upon defecation, scintigraphic assessment of colorectal transport during stimulation of the reflex arch, standard anorectal physiology tests and colorectal symptoms were performed at baseline and 18 months after surgery.Results: No significant change was observed in colorectal emptying upon defecation (median 31% of the rectosigmoid at baseline vs 75% at follow-up, P=0.50), no movement of colorectal contents was observed during stimulation of the reflex arch. Segmental colorectal transit times, anal sphincter pressures and rectal capacity did not change, and no change was seen in NBD score (median 13.5 (baseline) vs 12.5 (follow-up), P=0.51), St Marks fecal incontinence score (4.5 vs 5.0, P=0.36) and Cleveland constipation score (6.0 vs 8.0, P=0.75).Conclusions: The artificial somato-autonomic reflex arch has no effect on bowel function in subjects with supraconal SCI.

AB - Study design: Prospective cohort study.Objective: Although introduced for neurogenic bladder dysfunction, it has been suggested that the artificial somato-autonomic reflex arch alleviates neurogenic bowel dysfunction (NBD). We aimed at evaluating the effects of the reflex arch on NBD.Setting: Denmark.Methods: Ten subjects with supraconal spinal cord injury (SCI) (nine males, median age 46 years) had an anastomosis created between the ventral part of the fifth lumbar or first sacral nerve root and the ventral part of the second sacral nerve root. Standardized assessment of segmental colorectal transit times with radiopaque markers, evaluation of scintigraphic assessed colorectal emptying upon defecation, scintigraphic assessment of colorectal transport during stimulation of the reflex arch, standard anorectal physiology tests and colorectal symptoms were performed at baseline and 18 months after surgery.Results: No significant change was observed in colorectal emptying upon defecation (median 31% of the rectosigmoid at baseline vs 75% at follow-up, P=0.50), no movement of colorectal contents was observed during stimulation of the reflex arch. Segmental colorectal transit times, anal sphincter pressures and rectal capacity did not change, and no change was seen in NBD score (median 13.5 (baseline) vs 12.5 (follow-up), P=0.51), St Marks fecal incontinence score (4.5 vs 5.0, P=0.36) and Cleveland constipation score (6.0 vs 8.0, P=0.75).Conclusions: The artificial somato-autonomic reflex arch has no effect on bowel function in subjects with supraconal SCI.

UR - http://www.scopus.com/inward/record.url?scp=84928598991&partnerID=8YFLogxK

U2 - 10.1038/sc.2015.75

DO - 10.1038/sc.2015.75

M3 - Journal article

C2 - 25917948

AN - SCOPUS:84928598991

VL - 53

SP - 705

EP - 710

JO - Spinal Cord

JF - Spinal Cord

SN - 1362-4393

IS - 9

ER -