Effects of Lower Thoracic Spinal Cord Stimulation on Bowel Management in Individuals With Spinal Cord Injury.
Anthony F DiMarco, Robert T Geertman, Kutaiba Tabbaa and 2 others
PMID 33161007WHAT IT FOUND
Bowel routines dropped from 118 minutes to 18 minutes in five men with cervical spinal cord injury using implanted spinal cord stimulation.
Mechanical methods and medications became less necessary. This is a tiny case series, so it proves feasibility, not efficacy.
Key findings
01Mean bowel management time fell from 118 minutes pre-implant to 18 minutes at week 21.
02Two of five subjects no longer required mechanical methods, and the need for digital anorectal stimulation was eliminated in two of the three remaining subjects.
03Improvements in bowel time were directly related to increases in airway pressure generated by the stimulation.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study included only five subjects, all male, with cervical SCI. There was no control group or blinding; subjects knew they were receiving the treatment. The intervention is invasive, requiring surgical implantation of electrodes. The mechanism of action is inferred from airway pressure correlations rather than direct measurement of intra-abdominal pressure or colonic motility. Results need confirmation in a larger population sample.
Declared interests
Dr. DiMarco holds two United States Patents for technology related to the content of this paper. The study was supported by the N.I.H., Extramural.
The easy way to misread this
Do not interpret the 84% reduction in bowel time as proof that spinal cord stimulation is a superior or safe standard of care. This was an unblinded case series of only five people, and the intervention requires surgical implantation with risks of autonomic dysreflexia.