Abstract

Background: Spinal cord injury (SCI), whether complete or incomplete of supra-above D6 (SSCI as the autonomic supply of spinal cord is usually controlled and is situated here at D6 level) usually also presents with urinary problems of UMN type. Nitric oxide by virtue of its 10000-fold effect at synapse and neuromuscular junction has been shown excellent results in ASIA grading and also its predictability of improvements has been well demonstrated with the use of ALTENS (Acupressure Like Transcutaneous Epidermal Stimulation).

Objective: To access the urodynamic urinary bladder parameter improvements via 10000-fold effect by Intrathecal Sodium Nitroprusside (ITSNP) superfusion, on patients with supra spinal cord injury cases.

Material and Methods: A prospective one hospital-based study done on 9 patients from March 2014 to June 2020 with supra spinal cord injury. After taking written consent and video recording of the motor, sensory and bladder bowel involvement baseline ASIA, ALTENS and urodynamic study was performed, which was repeated after 2 hours. ASIA grading, ALTENS, Urodynamic parameters (like maximum detrusor filling pressures and maximum detrusor voiding pressures, maximum bladder capacity and bladder compliance) before after ITSNP were compared for final results.

Results: After ITSNP in all 9 patients, maximum bladder capacity 35.92%, bladder compliance 14.38%, maximum detrusor filling 9.14% and maximum detrusor voiding pressures 13% increase in urodynamic study. Less improvements noted in more than 5 months of bladder bowel involvement (BBI) cases than less than 5 months cases.

Conclusion: ITSNP is another modality via which ASIA grading 17.07%, ALTENS 25.55% and urodynamic parameters shows improvement such as maximum bladder capacity 35.92%, bladder compliance 14.38%, maximum detrusor filling 9.14% and maximum detrusor voiding pressures 13% increase, that is urinary bladder stores more urine with nearly same pressure, decreasing daily urination frequency.

Keywords: Intrathecal Sodium Nitroprusside; 10000-fold Effect; Suprasacral Spinal Cord Injury; Urodynamic Parameters

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Citation

Citation: Vinod Kumar Tewari., et al. “Role of 10000-Fold Effect in Improving Urodynamic Parameters with Supra Spinal Cord Injury”. Acta Scientific Neurology 3.11 (2020): 26-33.

Copyright

Copyright: © 2020 Vinod Kumar Tewari., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.