- CConnexion
RééDOC
75 Boulevard Lobau 54042 NANCY cedex Christelle Grandidier Documentaliste 03 83 52 67 64 0
|
Neurourologic findings in patients with traumatic thoracolumbar vertebra junction lesions
CHUANG TY; CHENG H; CHAN RC
ARCH PHYS MED REHABIL , 2001, vol. 82, n° 3, p. 375-379 Doc n°: 99832 Localisation : Documentation IRR Descripteurs : AH2 - TROUBLES MICTIONNELS
Article consultable sur : http://www.archives-pmr.org
OBJECTIVE: To investigate neurourologic involvement in injuries to the thoracolumbar vertebra junction with magnetic resonance imaging (MRI) and electrophysiologic and urodynamic measurements and to characterize the neurogenic mechanisms of voiding dysfunctions. DESIGN: Baseline comparisons among 3 anatomic groups before neural repair. SETTING: Tertiary care center. PATIENTS: Thirty-five T11 to L2 spinal cord injury patients consecutively admitted to a rehabilitation unit. Eight patients (Group 1) had above-conus lesions without denervation and polyphasic waves revealed in the anal sphincter electromyography; 13 patients (Group 2) had conal and/or above-conus lesions and anal sphincter electromyographic abnormalities; and 14 patients (Group 3) had below-conus lesions and anal sphincter electromyographic abnormalities. MAIN OUTCOME MEASURES: Comparison of features identified on pudendal nerve terminal motor latency, urethral pressure profiles, and multichannel voiding pressure-flow study. RESULTS: The pudendal nerve terminal motor latency in Group 3, showing a significantly higher abnormal ratio (100%; p =.011, Fisher's exact test), indicated that cauda equina lesions might be the cause. Urodynamic data from Group 3 showed a significant decrease in maximal urethral closure pressure (48 +/- 17cm H2O, p =.0022, analysis of variance [ANOVA], repeated measure) and an increase in bladder capacity (429 +/- 194mL, p =.037, ANOVA, repeated measure). There were no significant changes in the other groups. CONCLUSION: Neurourologic abnormalities are less predictable with injuries to thoracolumbar junction, except in patients with cauda equina lesions. Langue : ANGLAIS Identifiant basis : 2001215772 |
0
|