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  • Wise Young
    replied
    Originally posted by aviator
    I contacted Kenneth M. Peters, M.D. with William Beaumont Hospital who is performing the clinical trial that is linked in this thread. I had asked him if the surgery was available for me. I have an L1 burst fracture with Flaccid Bladder. Here is his response

    "Thanks for your e-mail. We are still doing this surgery as part of a research study and our results are too immature to report yet in the spinal cord injury, but we have good results in spina bifida. Unfortunately, your functional status is too good for the study. Patients need to be a paraplegic to be enrolled. That being said, it does not mean that it would not work for you. So perhaps in the future if it becomes common place we can do this surgery on you in hopes of regaining the bladder and bowel function. Otherwise, Dr. Xiao in China who developed the surgery may be able to perform this on you there."

    I just wanted to pass this along. Perhaps someone else can benefit from it.
    Aviator, thanks very much for this information. Wise.

    Leave a comment:


  • aviator
    replied
    I contacted Kenneth M. Peters, M.D. with William Beaumont Hospital who is performing the clinical trial that is linked in this thread. I had asked him if the surgery was available for me. I have an L1 burst fracture with Flaccid Bladder. Here is his response

    "Thanks for your e-mail. We are still doing this surgery as part of a research study and our results are too immature to report yet in the spinal cord injury, but we have good results in spina bifida. Unfortunately, your functional status is too good for the study. Patients need to be a paraplegic to be enrolled. That being said, it does not mean that it would not work for you. So perhaps in the future if it becomes common place we can do this surgery on you in hopes of regaining the bladder and bowel function. Otherwise, Dr. Xiao in China who developed the surgery may be able to perform this on you there."

    I just wanted to pass this along. Perhaps someone else can benefit from it.

    Leave a comment:


  • aviator
    replied
    Does anyone have an update on this trial?

    I just found this old thread where a nerve bridging trial was to begin. Does anyone have an update?

    Leave a comment:


  • Wise Young
    replied
    MikeC, it should work with people with cauda equina injuries.

    Alan, this procedure should be carried out by somebody experienced with doing this kind of work.

    Eric.S, in my opinion, this is still in phase 2 clinical trial. There is some promising data but not all the benefits, complications, and success rates of the surgery have been defined.

    Wise.

    Leave a comment:


  • alan
    replied
    Anyone in the Baltimore area do this surgery?

    Leave a comment:


  • Eric.S
    replied
    Is this still in trial phase?

    Leave a comment:


  • MikeC
    replied
    Dr Young, thanks for all of the information. In theory, would this procedure work on someone with a cauda equina injury?

    Mike

    Leave a comment:


  • Tufelhunden
    replied
    I don't take it that this is a reversible procedure?

    Leave a comment:


  • Schmeky
    replied
    May be the best SCI breakthrough we'll see for some time in regards to what is presently available.

    Leave a comment:


  • Tufelhunden
    replied
    "A year and half after the procedure, their creatine levels returned to normal. In addition, patients who regained bladder control also regained bowel control. Overall, by the end of 2004, 81 of 92 treated patients regained bladder function one year after surgery."

    How does bowel control play in all of this?

    Leave a comment:


  • medic1
    replied
    I am going to give this info to my doc. I am in Michigan, maybe I will have a shot. I am not sure if I would qualify because my injury is right at L1 and it says above L1. It would be so nice not to have to cath.

    Leave a comment:


  • metronycguy
    replied
    sounds lkike a breakthrough surgery! i hope it works

    Leave a comment:


  • Wise Young
    replied
    Originally posted by BeeBee
    The study group will be fowarding their information this week. Possible benefits are: return of bladder function, possible partial return of bowel function (control ability, not sensory) and possible possible sexual return.
    Reletively "minor" surgery: a 2 day stay and couple more days at home. (No large incisions or hardware placement: that's OUR definition of major surgery).
    Dr Young: do you have links or copies of the published research?

    Beebee, I am sorry but I don't have any additional information above what is on Medline and Google, which you have obtained. Dr. Xiao showed videos of his results in the December meeting of the ISCITT meeting in December (Source). I have to say that the videos of the urinary streams of his patients when they scratched their buttocks was quite amazing. Chuan-Guo Xiao, M.D. received the Grand Prize, International Jack Lapides Award on Urodynamic and Neurourology Research. If you do a search on internet, you will find a variety of articles about a controversial lawsuit that Dr. Xiao seemed to have been involved in. I have met the man several times and think that he is a legitimate urologist and very much committed to this procedure for improving the lives of people with spinal cord injury.

    Wise.

    The clinical trial information is on
    http://www.med.nyu.edu/fgpurology/clinical/
    Spinal Cord Injury

    Title: Skin-CNS-Bladder Reflex Arc for Micturition after SCI

    Prinicipal Investigator: Chuan-Guo Xiao, M.D.

    Purpose: The purpose of this research is to restore bladder function after a spinal cord injury and allow the subject to have voluntary control of bladder emptying. Since the spinal cord injury, the subject must have difficulty urinating and need assistance with a tube to insert into their bladder to allow urine to flow. As a part of this study, the subject would undergo a surgical procedure in which two of their nerves which have been paralyzed below the level of their spinal cord injury will be connected to other nerves, hoping to regenerate the paralyzed ones. Normally, it takes 12-18 months for these nerves to regenerate so that the subject will not have any change in their current bladder function until 12-18 months after their surgery. At that time, the subject would voluntarily start their urination by scratching their skin.
    The description of the procedure is given at

    4) Dr. Chuan-Guo Xiao and colleagues (Wuhan, China & New York, USA) have rerouted nerves below the injury site, restoring the patient’s ability to control urination through skin stimulation (J Urol, 170, 2003; & European Urology 49, 2006). As illustrated, the lumbar-level L5 ventral nerve root is usually connected to the sacral-level S3 (or S2) ventral nerve root. (The ventral and dorsal roots contain nerves that leave and enter the spinal cord, respectively). After rerouting, by scratching, gently squeezing, or electro-stimulation of the skin associated with the L5 dermatome, a voiding response is initiated. Basically, these actions trigger a sensory signal that enters the cord via the L5-dorsal root, in turn, stimulating nerves that leave the cord through the L5-ventral roots now connected to the bladder-controlling S3-ventral nerve root. Provided this area of rerouting is undamaged, the procedure is suitable for all levels of injury. Because this procedure does not restore bladder sensation, patients need to consciously initiate the triggering procedures for urination.



    In his 2003 article, Xiao reported the results of treating 15 patients with complete, ASIA-A injuries with this procedure. Injuries ranged from C4 to T12; in other words, all were well above the nerve-rerouting area. The time between injury and surgery averaged 6.8 years, and average follow-up was three years. Of the 15 patients, 10 recovered bladder-storage and emptying function starting about a year after surgery (the time for regenerating neurons to reach their target site), residual urine decreased from 332 to 31 milliliters, and urinary-tract infections became negligible. In addition, two patients partially recovered, requiring electrical stimulation to initiate voiding, and, although decreasing residual urine, still retaining over 100 milliliters. Of the three remaining patients, one was lost to follow-up, and two did not accrue benefits, apparently due to poor rerouting connections.

    Before surgery, six of the 12 patients who eventually recovered bladder control had elevated serum creatine levels, an indicator of kidney problems. A year and half after the procedure, their creatine levels returned to normal. In addition, patients who regained bladder control also regained bowel control. Overall, by the end of 2004, 81 of 92 treated patients regained bladder function one year after surgery.
    Here is some more info:
    http://www.globalforumhealth.org/rea...ws/RHNews1.pdf

    The newsletter of real action and research, No.1, March 2005

    Chinese neurologist "straddles two boats"

    Xiao Chuan-guo Bringing US$1 million of equipment with him from the US, Xiao
    Chuan-guo was one of the first. But he keeps a post in the West.

    1976... As a young doctor who just graduated from Hubei Medical College...
    Moving to the UK and then the US

    In 1995, in very restricted conditions, Xiao began operations on paraplegic
    miners at the Pingding Mountain Mine.

    Xiao formally returned to China in 1997. Chen Mingzhang, then Minister of
    Health, invited him back, offering RMB 500 000 (US$ 62 500) as a research
    start-up fund. And with the approval of the US National Institutes of Health, he
    also took along with him his complete laboratory, worth US$1 million, in a
    shipping container – and paid the shipment fee himself.

    Appointed Professor and Chairman of the Urology Department Tongji Medical
    College, he was encouraged by the College to take concurrent posts abroad. So
    Xiao has continued to serve as a Principal Investigator at the Departments of
    Urology and Neurosurgery of the New York University School of Medicine.

    This policy, allowing expatriate scientists to "straddle two boats at the
    same time" (in the Chinese idiom) helps Xiao retain his place in
    international research. He travels back and forth frequently, and is a
    soughtafter researcher and surgeon in both countries.
    Here is his curriculum vitae
    http://www.hust.org/hust/post/html/A1/1050.html

    CURRICULUM VITAE September 3, 2004
    Name: Chuanguo Xiao, 肖传国 Male
    E-mail: xiaoc01 @ med . nyu . edu Cellular: 13707136268

    EDUCATION:[学历]
    8/1988-12/1990 AUA Fellow, Neurourology & Reconstructive Urology
    Eastern Virginia Medical School, Norfolk, VA

    8/1987 7/1988 Fellow, Institute of Urology,
    University College London, UK

    10/1978 10/1981 Tongji Medical University Graduate College
    Dept.Urology, Union Hospital, Wuhan, P.R.China

    2/1972 12/1975 Hubei Medical College, Wuhan, P.R.China

    APPOINTMENTS AND POSITIONS[工作经历和任职]
    2001.1-Present Associate Professor
    Department of Urology
    New York University School of Medicine

    1991.1-2001.12 Director of Urologic Research,
    Director of New York Kidney Stone Center
    Long Island College Hospital, Brooklyn, NY

    1997.6-Present Professor and Chairman, Department of Urology,
    Director, Institute of Urology(2002-)
    Tongji Medical University, P.R.China

    1991.1-2000.12 Assistant Professor, Department of Urology
    State University of NY HSC at Brooklyn,NY

    1988.7 1990.12 Instructor in Urology and Neuroanatomy
    Eastern Virginia Medical School, Norfolk, VA

    1987.8 1988.7 "Sino British Exchange Scholar" in oncology,
    Institute of Urology, University College London, U.K.

    1981.9 1987.7 Attending Urologist & Lecturer, Department of Urology
    Tongji Medical University, P.R.China

    1978.9 1981.8 Resident and Chief Resident, Department of Urology,
    Tongji Medical University, P.R.China

    1976.1 1978.8 Resident, Department of Surgery, Puqi City General
    Hospital, Hubei, China
    HONORS AND MEMBERSHIPS
    1987: 湖北省卫生厅科技一等奖---第一完成人
    1987 1988: Sino British Exchange Scholarship in UCL, UK
    1988 1990: America Urological Association Fellowship in Neurourology
    1993: Jack Lapides International Neurourology Award
    2000: America Urological Association Achievement Award
    2000: Jie-Pin Wu International Urological Award[吴阶平医学奖]
    2000: 中国教育部自然科学一等奖---第一完成人]
    2000: 湖北省自然科学一等奖—--第一完成人
    2001: 中国国家科技进步二等奖---第一完成人
    2001- 华中科技大学(同济医学院)特聘教授
    2002: 何梁何利医药奖
    2003: American Urology Association Lapides Grand Prize Award
    Since 1993: NIH consultant(SAT group: Surgery, Anesthesia & Trauma)
    Since 1992: Member of American Urological Association
    Member of International Medical Society of Paraplegia
    1991 -2000: Members of IACUC and Research Advisory Committee of the
    Long Island College Hospital, SUNY

    GRANTS (as Principal Investigator only)在美国的基金PI
    1. Grant (IFR 89 15) from Eastern Virginia Medical School for "

    (Professor Xiao Chuan-Guo, Tongji Med Coll. HUST)

    Bladder reinnervation after spinal cord injury", $2,500 for one year.
    (1989)

    2. Grant(SCRF830 01) xxxx Spinal Cord Research Foundation, Paralyzed
    Veterans of America, for "Bladder reinnervation by anastomosis of L4
    VR to L6 VR while leaving the intact L4 DR as starter of micturition".
    $ 39,620 for one year (1990)

    3. Grant (SCRF 946) from Spinal Cord Research Foundation, Paralyzed
    Veterans of America, for " Skin CNS Bladder reflex pathway for
    micturition after spinal cord injury". $45,680 (3/91 8/92)

    4. Source: NIH (NIDDK) R01 DK 44877 01A1 (Animal study)
    Title: Skin CNS Bladder reflex pathway for micturition.
    Amount: $328,884 (direct costs)
    Period: 12/1993 12/1997

    5. Source: NIH (NIDDK) R01 DK 53063 01A2 (Human study)
    Title: Skin CNS Bladder reflex pathway for micturition.
    Amount: $2,423,082 (direct costs)
    Period: 9/1999 9/2004

    国内基金课题负责人或首席科学家)
    1997-2000: 卫生部重点项目:神经性膀胱新疗法的机理与临床研究— 60万(人民
    币,下同)
    1998-1999: 自然科学基金委: 人工体神经-内脏神经反射弧的机理  4万
    1999-2002: 自然科学基金委全国重点项目: 人工体神经-内脏神经反射弧的机理
     90万
    2000-2003: 自然科学基金委杰出青年基金  80万
    2003-2008: 973项目首席科学家: 神经损伤和功能重建的应用基础研究 2500万
    PUBLICATIONS (As First and Corresponding author only)

    1. Xiao CG., Du M., Li B., Liu Z. Chen M., Xue XN. Shapiro and Lepor H:
    An Artificial Somatic-Autonomic Reflex Pathway Procedure for Spina
    Bifida Children to Gain Bladder Control J. Urol. In Press.

    2. Xiao CG., Du M., Dai C., Li B., Nitti WV. and de Groat WC.: An
    artificial somatic-autonomic reflex pathway for controllable
    micturition after SCI: Preliminary results of 15 patients. J. Urol.
    170:1237-1241,2003.

    3. Xiao, CG and Li, B: Retrograde neurotracing study on
    skin-CNS-Bladder reflex pathway. Chn.J. Exp. Surg. 19:571-572,2002.

    4. Xiao CG and Li, B: LM and EM study on ultra structures of foreign
    nerve regeneration. Chn. J. Exp. Surg. 20:59-60,2003

    5. Xiao CG., deGroat, WC., Godec CJ., Dai, C. and Xiao, Q.:
    "Skin-CNS-Bladder" reflex pathway for micturition after spinal cord
    injury and its underlying mechanisms. J. Urol.162:936-942, 1999

    6. Xiao CG., Godec, CJ., Du, MX., Dai, C., and Xiao, Q.,: A new
    procedure to restore bladder functions after SCI: Preliminary report
    on 14 patients. J.Urol. 159:304A, 1998

    7. Xiao CG., Godec, CJ., Du, MX., Dai, C., and Xiao, Q.,: Complete
    bladder function restoration by skin-CNS-Bladder reflex pathway
    procedure in spinal cord injured patients. J. Urol. 157:1374A, 1997

    8. Xiao CG., Godec, CJ., Du, MX.: Skin-CNS-Bladder reflex pathway for
    micturition in spinal cord injury patients. Proceedings of the 48th
    Annual Meeting of North Eastern Section American Urological Association,
    Buffalo, New York. September 26-29, 1996.

    9. Xiao CG. and Godec, CJ.: Mechanism underlying the Skin-CNS-Bladder
    reflex pathway. Proceedings of the 1995 Annual Scientific Meeting of
    the International Medical Society of Paraplegia, New Delhi, India. 2-4
    November 1995

    10. Xiao CG., Godec, CJ.: A "bi-bladder" model for study of cross
    neural communication related to micturition. J. Urol. 153:262A, 1995

    11. Xiao CG., Godec, CJ.: A possible new reflex pathway for
    micturition after SCI. Paraplegia. 32(5):300 307, 1994

    12. Xiao CG., Godec, CJ: Grunberger, I. and Macchia, RJ.: Skin CNS
    Bladder reflex pathway for micturition after SCI in cat. J. Urol.
    146:437A, 1992

    13. Xiao CG., Schellhammer, PF., Castle, M., and Brothman, AR.: Effect
    of MgCl2 on intracellular mitomycin C concentration. J. Urol. 145:66A,
    1991

    14. Xiao, CG., Grunberger I., and Godec, CJ.: "Skin CNS Bladder"
    reflex pathway for micturition after spinal cord injury. (Abstract #749)
    22nd Congress of Society of International Urology, November 3 7, 1991,
    Sevilla, SPAIN

    15. Xiao, CG., Schlossberg, SM., Morgan, CW. and Kodama R.: A possible
    new reflex pathway for micturition after spinal cord injury. J. Urol.
    143:356A, 1990.

    16. Xiao, CG. and Masters, JRW.: Combined intravesical chemotherapy
    with metal elements. J.Urol. 143:256A, 1990.

    17. Xiao, CG. and Masters, JRW.: Spectrum of differential drug
    sensitivities in vitro of a testicular germ cell tumor. British J.
    Cancer 58:230, 1988.

    18. Xiao, CG. and Xiong, XL.: Effect of trace elements on kinetics of
    calcium oxalate crystallization. J. Tongji Med. Univ. 6:100, 1986

    19. Xiao, CG.: Renal vascular hypertension in children: Etiology and
    treatment. Chn.J.Kidney. 4:319 1987

    20. Xiao, CG. and Xiong, XL.: Sr as a strong inhibitor of Calcium
    oxalate crystallization in vitro and in vivo. Chn.J.Urol. 6:24 1987

    21. Xiao, CG.: Mo and uric acid metabolism, a possible factor related
    to urinary stone xxxxation. Clin.Urol. 2:11 1987

    22. Xiao, CG, and Xiong, XL.: Research on trace elements for
    urolithiatic inhibitors. Chn. J.Urol. 5:57 1986

    23. Xiao, CG.,and Xiong, XL.: The role of Mg in Urolithiasis. Chn. J.
    Exp. Surg. 1:23 1984

    24. Xiao, CG. and Xiong, XL.: A study on the components, structure and
    xxxxation of urinary stone. J.Wuhan Medical College, 2:175, 1982

    25. Xiao, CG.:Advanced research on urolithiasis, Chapter 5 in ADVANCED
    UROLOGY IN CHINA, by T.J.Mu, 1st Edition, Shanghai Science and
    Technology press. Shanghai, 1988.

    Xiao, CG.:`Urinary stone diseases', Chapter 6, `Renal vascular
    hypertention', Chapter 10 ,in CLINICAL UROLOGY by Xiong, X.L., 2nd
    Edition, Hubei People Press
    Here is a recent abstract
    http://cat.inist.fr/?aModele=afficheN&cpsidt=16785651
    Titre du document / Document title
    An artificial somatic-autonomic reflex pathway procedure for bladder control in children with spina bifida
    Auteur(s) / Author(s)
    XIAO Chuan-Guo (1 2) ; DU Mao-Xin (3) ; BING LI (1) ; ZHAO LIU (1) ; MING CHEN (1) ; CHEN Zhao-Hui (1) ; PING CHENG (1) ; XUE Xiao-Nan (4) ; SHAPIRO Ellen (2) ; LEPOR Herbert (2) ;
    Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)
    (1) Department of Urology, Tongji Medical College, Xiehe Hospital, Huazhong University of Science and Technology, Wuhan, CHINE
    (2) Department of Urology, New York University School of Medicine, New York, New York, ETATS-UNIS
    (3) Department of Neurosurgery, Tongji Medical College, Xiehe Hospital, Huazhong University of Science and Technology, Wuhan, CHINE
    (4) Division of Biostatistics, Department of Epidemiology and Population Health at Albert Einstein College of Medicine, ETATS-UNIS
    Résumé / Abstract
    Purpose: Neurogenic bladder is a major problem for children with spina bifida. Despite rigorous pharmacological and surgical treatment, incontinence, urinary tract infections and upper tract deterioration remain problematic. We have previously demonstrated the ability to establish surgically a skin-central nervous system-bladder reflex pathway in patients with spinal cord injury with restoration of bladder storage and emptying. We report our experience with this procedure in 20 children with spina bifida. Materials and Methods: All children with spina bifida and neurogenic bladder underwent limited laminectomy and a lumbar ventral root (VR) to S3 VR microanastomosis. The L5 dorsal root was left intact as the afferent branch of the somatic-autonomic reflex pathway after axonal regeneration. All patients underwent urodynamic evaluation before and after surgery. Results: Preoperative urodynamic studies revealed 2 types of bladder dysfunction- areflexic bladder (14 patients) and hyperreflexic bladder with detrusor external sphincter dyssynergia (6). All children were incontinent. Of the 20 patients 17 gained satisfactory bladder control and continence within 8 to 12 months after VR microanastomosis. Of the 14 patients with areflexic bladder 12 (86%) showed improvement. In these cases bladder capacity increased from 117.28 to 208.71 ml, and mean maximum detrusor pressure increased from 18.35 to 32.57 cm H20. Five of the 6 patients with hyperreflexic bladder demonstrated improvement, with resolution of incontinence. Urodynamic studies in these cases revealed a change from detrusor hyperreflexia with detrusor external sphincter dyssynergia and high detrusor pressure to nearly normal storage and synergic voiding. In these cases mean bladder capacity increased from 94.33 to 177.83 ml, and post-void residual urine decreased from 70.17 to 23.67 ml. Overall, 3 patients failed to exhibit any improvement. Conclusions: The artificial somatic-autonomic reflex arc procedure is an effective and safe treatment to restore bladder continence and reverse bladder dysfunction for patients with spina bifida.
    Revue / Journal Title
    The Journal of urology (J. urol.) ISSN 0022-5347 CODEN JOURAA
    Source / Source
    2005, vol. 173, no6, pp. 2112-2116 [5 page(s) (article)] (12 ref.)
    Langue / Language
    Anglais
    http://cat.inist.fr/?aModele=afficheN&cpsidt=15120929
    Titre du document / Document title
    An artificial somatic-central nervous system-autonomic reflex pathway for controllable micturition after spinal cord injury: Preliminary results in 15 patients
    Auteur(s) / Author(s)
    XIAO Chuan-Guo (1 2) ; DU Mao-Xin (1) ; CHENGPU DAI (3) ; BING LI (1) ; NITTI Victor W. (2) ; DE GROAT William C. (4) ;
    Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)
    (1) Department of Urology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, CHINE
    (2) Department of Urology, New York University School of Medicine, New York, New York, ETATS-UNIS
    (3) Department of Orthopedics and Microsurgery, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, CHINE
    (4) Department of Pharmacology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, ETATS-UNIS
    Résumé / Abstract
    Purpose: Neurogenic bladder dysfunction after spinal cord injury (SCI) is a major medical and social problem for which there is no definitive solution. After the successful establishment in animals of a skin-central nervous system-bladder reflex pathway for micturition we performed this procedure on 15 patients with SCI who had 3 years of followup. Materials and Methods: A total of 15 male volunteers with hyperreflexic neurogenic bladder and detrusor external sphincter dyssynergia (DESD) caused by complete suprasacral SCI underwent limited hemilaminectomy and ventral root (VR) micro anastomosis, usually between the L5 and S2/3 VRs. The L5 dorsal root was left intact as the trigger of micturition after axonal regeneration. Mean followup was 3 years. All patients underwent urodynamic evaluation before surgery and during followup. Results: Preoperative studies in patients with complete suprasacral SCI revealed hyperreflexic neurogenic bladders and DESD with some differences in storage function during infusion cystometrograms. Of the 15 patients 10 (67%) regained satisfactory bladder control within 12 to 18 months after VR micro anastomosis. Average residual urine decreased from 332 to 31 ml and urinary infection as well as overflow incontinence disappeared. Urodynamic studies revealed a change from detrusor hyperreflexia with DESD and high detrusor pressure to almost normal storage and synergic voiding without DESD. Impaired renal function returned to normal. Two patients (13%) who required a skin stimulator to evoke voiding following the VR anastomosis had partial recovery but more than 100 ml residual urine. One patient was lost to followup and 2 had failure. Conclusions: An artificial somatic-central nervous system-autonomic reflex arc can be established surgically to provide a novel method for controlling bladder function in patients with complete suprasacral SCI who have hyperreflexic bladder and DESD. Nerve impulses delivered from the efferent neurons of a somatic reflex arc can be transferred to initiate the response of an autonomic effector.
    Revue / Journal Title
    The Journal of urology (J. urol.) ISSN 0022-5347 CODEN JOURAA
    Source / Source
    2003, vol. 170 (1), no4, pp. 1237-1241 [5 page(s) (article)] (19 ref.)
    There is an interesting article about Dr. Xiao at http://www.globalforumhealth.org/rea...ws/RHNews1.pdf

    Here is the clinicaltrial.gov blurb about the trial:
    http://www.clinicaltrials.gov/ct/sho...D67D94?order=6

    While searching through internet, I came across this defamation suit
    http://69.65.19.163/~nodomain/xwh/06/11/99046.html
    http://www.rainbowplan.org/bbs/topic...elect=&forum=1

    Note that Xiao has received an NIH grant for his work, as Steven Edwards pointed out in /forum/showthread.php?t=67720

    Here is an abstract of his work on the electrophysiology of spinal roots:
    http://scholar.ilib.cn/Abstract.aspx...szz-e200502002
    Electrophysiological monitoring and identification of neural roots during somatic-autonomic reflex pathway procedure for neurogenic bladder


    <<中华创伤杂志英文版 >>2005年02期
    DAI Cheng-fu , XIAO Chuan-guo

    Objective: To identify and separate the ventral root from dorsal root, which is the key for success of the artificial somatic-autonomic reflex pathway procedure for neurogenic bladder after spinal cord injury (SCI). Here we report the results of intra-operating room monitoring with 10 paralyzed patients.Methods: Ten male volunteers with complete suprasacral SCI underwent the artificial somatic-autonomic procedure under general anesthesia. Vastus medialis, tibialis anticus and gastrocnemius medialis of the left lower limb were monitored for electromyogram (EMG) activities resulted from L4, L5, and S1 stimulation respectively to differentiate the ventral root from dorsal root. A Laborie Urodynamics system was connected with a three channel urodynamic catheter inserted into the bladder. The L2 and L3 roots were stimulated separately while the intravesical pressure was monitored to evaluate the function of each root.Results: The thresholds of stimulation on ventral root were 0.02 ms duration, 0.2-0.4 mA, (mean 0.3 mA±0.07 mA), compared with 0.2-0.4 ms duration, 1.5-3 mA (mean 2.3 mA±0.5 mA)for dorsal root (P<0.01) to cause revoked potentials and EMG. Electrical stimulation on L4 roots resulted in the EMG being recorded mainly on vastus medialis, while stimulation on L5 or S1 roots caused electrical activities of tibialis anticus or gastrocnemius medialis respectively. The continuous stimulation for about 3-5 seconds on S2 or S3 ventral root (0.02 ms, 20 Hz, and 0.4 mA) could resulted in bladder detrusor contraction, but the strongest bladder contraction over 50 cm H2O was usually caused by stimulation on S3 ventral root in 7 of the 10 patients.Conclusions: Intra-operating room electrophysiological monitoring is of great help to identify and separate ventral root from dorsal root, and to select the appropriate sacral ventral root for best bladder reinnervation. Different parameters and thresholds on different roots are the most important factors to keep in mind to avoid damaging the roots and to assure the best results.

    Leave a comment:


  • lynnifer
    replied
    I'll be watching with heightened interest ... I put a bug in my urologist's ear last Wednesday about this ... he's pretty open-minded and I see him again first thing in January.

    Leave a comment:


  • MikeC
    replied
    BeeBee - the best of luck to your son. Sure do hope the procedure is successful. Do you know where/if he will lose sensation because of the nerve rerouting? Mike

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