Acta Scientific Neurology (ASNE) (ISSN: 2582-1121)

Research Article Volume 3 Issue 11

Role of 10000-Fold Effect in Improving Urodynamic Parameters with Supra Spinal Cord Injury

Vinod Kumar Tewari1*, Devesh Johari2, Lori Tewari3 and Neeraj4

1Neurosurgeon, Director, Advance Neuro and General Hospital, Lucknow, India
2Opthalmologist, PMS, Jodhpur, Rajasthan, India
3Advance Neuro and General Hospital, Lucknow, India
4Physiotherapist, Advance Neuro and General Hospital, Lucknow, India

*Corresponding Author: Vinod Kumar Tewari, Neurosurgeon, Director, Advance Neuro and General Hospital, Lucknow, India.

Received: September 19, 2020; Published: October 22, 2020

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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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References

  1. Wein AJ., et al. “Lower urinary tract dysfunction in neurologic injury and diseases primarily involving the spinal cord”. Campbell-Walsh Urology. 9th Philadelphia PA: Saunders Elsevier (2007).
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  3. Vinod K., et al. “The 10,000-Fold-Effect-Retrograde Neurotransmission- A Newer Concept for Paraplegias Physiological Revival-Use of Intrathecal Sodium Nitroprusside”. Journal of Evolution of Medical and Dental Sciences 26 (2013): 7270-7285.
  4. Goodman and Gilman’s the pharmacological basis of therapeutics 12th edition page number 783 and page 796.
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  7. Tewari VK., et al. “Acupuncture-like TENS (AL-TENS) as a Quantitative Measure for the Feasibility of Intrathecal Sodium Nitroprusside Superfusion in Paraplegics for Physiological Recovery—A Pilot Study (13 Cases)”. Journal of Spine Surgery2 (2019): 44-48.
  8. Vasiliadis AV. “Epidemiology map of traumatic spinal cord injuries:a global overview”. International Journal of Caring Sciences 3 (2012): 335-347.
  9. Whiteneck GG., et al. “Mortality, morbidity and osychosocial outcomes of persons spinal cord injured more then 20 years ago paraplegia”. 30.9 (1992): 617-630.
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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.




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Acceptance rate32%
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