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Titolo:
Tailored laminectomy: A new technique for neuromodulator implantation
Autore:
Braun, PM; Boschert, J; Bross, S; Scheepe, JR; Alken, P; Juenemann, P;
Indirizzi:
Univ Hosp, Dept Urol, Mannheim, Germany Univ Hosp Mannheim GermanyUniv Hosp, Dept Urol, Mannheim, Germany Univ Hosp, Dept Neurosurg, Mannheim, Germany Univ Hosp Mannheim GermanyUniv Hosp, Dept Neurosurg, Mannheim, Germany
Titolo Testata:
JOURNAL OF UROLOGY
fascicolo: 5, volume: 162, anno: 1999,
pagine: 1607 - 1609
SICI:
0022-5347(199911)162:5<1607:TLANTF>2.0.ZU;2-R
Fonte:
ISI
Lingua:
ENG
Soggetto:
URINARY-TRACT DYSFUNCTION; NERVE-STIMULATION; ELECTRICAL-STIMULATION; VOIDING DYSFUNCTIONS; ROOT NEUROMODULATION; URGE INCONTINENCE; MANAGEMENT; BLADDER; PAIN;
Keywords:
neurotransmitters; sacrococcygeal region; laminectomy; urinary incontinence; bladder;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
20
Recensione:
Indirizzi per estratti:
Indirizzo: Braun, PM Univ Hosp, Dept Urol, Mannheim, Germany Univ Hosp Mannheim Germany Hosp, Dept Urol, Mannheim, Germany
Citazione:
P.M. Braun et al., "Tailored laminectomy: A new technique for neuromodulator implantation", J UROL, 162(5), 1999, pp. 1607-1609

Abstract

Purpose: Neuromodulation of sacral roots is an alternative mode of therapyfor patients with urge incontinence or detrusor hypocontractility. We investigated the effects of sacral (S3) nerve stimulation in patients using a new surgical approach for sacral neuromodulator implantation. Modification of the implantation method with sacral laminectomy and bilateral electrode placement led to distinct improvement of stimulation, positioning and dislocation. We developed tailored laminectomy for bilateral neuromodulator electrode implantation to minimize surgical trauma. Materials and Methods: Tailored laminectomy was performed in 6 patients with urge incontinence and 3 with a hypocontractile detrusor. After making a 10 cm. longitudinal skin incision we exposed the spinous processes of S2 and S3. Instead of complete 2-level laminectomy, only 2 oval laminectomy holes were made with a high speed ball drill. An electrode fixation hole was drilled at the edge of the laminectomy window and the wire was fixed with nonabsorbable suture material. Results: In patients with idiopathic urge incontinence (followup 12.5 months, range 7 to 18) the number of leaks decreased from 7.2 to 0 daily and functional bladder capacity increased from 298 to 352 ml. In patients with a hypocontractile detrusor (followup 10.5 months, range 6 to 20) detrusor pressure increased during voiding from 12 to 34 cm. water and post-void residual decreased from 350 to 58 mi. Average surgery time was 2 hours 15 minutes. In 1 case a seroma developed near the impulse generator. Conclusions: Tailored laminectomy is a fast, minimally invasive and reliable technique for neuromodulator implantation.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 12/07/20 alle ore 06:35:29