Bladder compliance after posterior sacral root rhizotomies and anterior sacral root stimulation

To evaluate the effects of central detrusor denervation on bladder compliance, we studied 27 patients with complete suprasacral spinal cord injury in whom intradural posterior sacral root rhizotomies from S2 to S5 in combination with implantation of an intradural Finetech-Brindley bladder stimulator were performed. All patients initially presented with detrusor hyperreflexia. A majority of these patients had a decreased bladder compliance 5 days postoperatively followed by a rapid increase in bladder compliance thereafter. All patients showed persistent detrusor areflexia after long-term followup. In 2 patients incomplete posterior sacral rhizotomies appeared to be performed. These patients had low bladder compliance, so that secondary posterior sacral root rhizotomies at the level of the conus medullaris were done. Intradural rhizotomies of all posterior sacral root components from S2 to S5 in combination with implantation of an anterior sacral root stimulator is a safe and effective procedure in spinal cord injury patients.