{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T02:12:52Z","timestamp":1782526372603,"version":"3.54.5"},"reference-count":16,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2009,5]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Neurogenic bladder dysfunction following spinal cord injury (SCI) is a major medical and social problem for which there is no ideal treatment strategy. In the present study, the authors analyze the effectiveness of neurogenic bladder reinnervation in patients with SCIs by using Achilles tendon reflexes below the paraplegic level.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Spinal root anastomoses were performed in 12 paraplegic patients with hyperreflexic neurogenic bladder and detrusor external sphincter dyssynergia (DESD) caused by complete suprasacral SCI, in an attempt to reinnervate the bladder. The surgery anastomosed the unilateral proximal end of the S-1 ventral root and the distal end of the S-2 and\/or S-3 ventral roots to build the Achilles tendon\u2013to-bladder reflex, while the S-1 dorsal root was kept intact as the trigger for micturition after axonal regeneration. All patients underwent urodynamic evaluation before surgery and at follow-up.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The mean follow-up duration was 3 years. Of the 12 patients, 9 (75%) regained satisfactory bladder control within 6 to 12 months after ventral root microanastomosis. In these 9 patients, urodynamic studies revealed a change from detrusor hyperreflexia with DESD and high detrusor pressure to almost normal storage and synergic voiding without DESD. The average bladder capacity increased from 258 \u00b1 33 ml to 350 \u00b1 49 ml, residual urine decreased from 214 \u00b1 36 ml to 45 \u00b1 11 ml, and urinary infections were not observed. Patients with impaired renal function experienced a full recovery. Three patients failed to show any improvement after the operation.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>These results suggest the effectiveness of bladder innervation below the level of SCI to produce urination by Achilles tendon\u2013to-bladder reflex contractions, and might therefore provide a new clinical approach to reconstructing spasmodic bladder urination function.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2009.1.spine08540","type":"journal-article","created":{"date-parts":[[2009,9,28]],"date-time":"2009-09-28T22:26:29Z","timestamp":1254176789000},"page":"452-457","source":"Crossref","is-referenced-by-count":40,"title":["Clinical study of reconstructed bladder innervation below the level of spinal cord injury to produce urination by Achilles tendon\u2013to-bladder reflex contractions"],"prefix":"10.3171","volume":"10","author":[{"given":"Haodong","family":"Lin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunlin","family":"Hou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianyou","family":"Zhen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0100452","series-title":"Paraplegia","first-page":"795","article-title":"The first 500 patients with sacral anterior root stimulator implants: general description","volume":"32","author":"Brindley","year":"1994"},{"key":"b2-0100452","series-title":"Rev Surg","first-page":"73","article-title":"Reconstruction of efferent pathway to the urinary bladder in a paraplegic child","volume":"24","author":"Carlsson","year":"1967"},{"key":"b3-0100452","series-title":"Microsurgery","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1002\/micr.1920120403","article-title":"Root reconstruction for bladder reinnervation: an experimental study in rats","volume":"12","author":"Chuang","year":"1991"},{"key":"b4-0100452","series-title":"J Urol","doi-asserted-by":"publisher","first-page":"1036","DOI":"10.1016\/S0022-5347(05)64569-7","article-title":"Magnetic stimulation of the sacral roots for the treatment of urinary frequency and urge incontinence: an investigational study and placebo controlled trial","volume":"168","author":"Fujishiro","year":"2002"},{"key":"b5-0100452","series-title":"J Urol","doi-asserted-by":"publisher","first-page":"1207","DOI":"10.1016\/S0022-5347(17)36862-3","article-title":"Selective sacral rhizotomy of the reflex neuropathyic bladder: a report on 17 patients with long-term follow-up","volume":"148","author":"Gasparini","year":"1992"},{"key":"b6-0100452","series-title":"Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi","first-page":"10","article-title":"[Experimental study on establishment of artificial bladder after spinal cord injury.]","volume":"14","author":"Hou","year":"2000"},{"key":"b7-0100452","series-title":"Plast Reconstr Surg","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1097\/00006534-199708000-00020","article-title":"Functional urinary bladder wall substitute using a free innervated latissimus dorsi muscle flap","volume":"100","author":"Ninkovi\u0107","year":"1997"},{"key":"b8-0100452","series-title":"Neurourol Urodyn","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1002\/nau.20014","article-title":"Functional magnetic stimulation of the spinal cord: a urodynamic study in healthy humans","volume":"23","author":"Reitz","year":"2004"},{"key":"b9-0100452","series-title":"J Urol","doi-asserted-by":"publisher","first-page":"1103","DOI":"10.1016\/S0022-5347(01)65150-4","article-title":"Free neurovascular transfer of latissimus dorsi muscle to the bladder: experimental studies","volume":"157","author":"Stenzl","year":"1997"},{"key":"b10-0100452","series-title":"Scand J Urol Nephrol","doi-asserted-by":"publisher","first-page":"185","DOI":"10.3109\/00365597209133635","article-title":"Reconstruction of severed dorsal roots innervating the urinary bladder. 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