ABSTRACT
The aim of this procedure is to reconstruct the defecation and urinary functions in paraplegic patients. In 30 patients, two normal vascularized intercoastal nerves above the paraplegic level were isolated and their distal ends divided. They were transferred to the vertebral canal through a submuscular tunnel. The sural nerve was harvested with enough length and separated into two segments, which were sutured as a bridge with S 2-4 nerve roots by interfascicular neurorrhaphy in patients with spinal cord injury above T 11 or with S 2-4 nerve roots outside of the vertebral canal in patients with spinal cord injury below T 12. After 2 to 11-year (mean 5 years) follow-up, 26 (86.6%) patients regained partial micturition reflex and defecation reflex, and partial sensation (S1-2) in buttock, perineal and vulva regions. In 23 (76.7%) patients had also recovery of the function of voluntary urination, and 8 (27%) of them showed partial recovery of function of the detrusor muscle, urethral sphincter, and anal sphincter. The results showed that the procedure described above could be used as an alternative method to reconstruct the function of defecation and urination, and also partial sensation of perineal and vulval region in a part of paraplegic patients.
