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. Author manuscript; available in PMC: 2011 Jun 18.
Published in final edited form as: Spinal Cord. 2010 Mar 9;48(10):718–733. doi: 10.1038/sc.2010.14

Table 10.

Implanted Electrical Stimulation Systems

Author Year; Country
Score
Research Design
Total Sample Size		 Methods Outcome
Chia et al. 1996;52 Singapore
Downs & Black score=14
Pre-post
N=8		 Population: Mean age: 40, range 20–53 years; Level of injury: C4-T11.
Treatment: Implantation of anterior sacral roots electrodes.
OM: Bowel frequency, laxative use, suppository use, need for digital evacuation, anorectal monometry

  1. 6 patients had improved bowel function: 4 were able to evacuate spontaneously after stimulation

  2. The 6 patients with improved bowel routine also showed a positive rectoanal pressure difference immediately after stimulation.
Kachourbos & Creasey 2000;53 USA
Downs & Black score=12
Pre-post
N= 16		 Population: Patients with a history of bowel complications
Treatment: Implantation of sacral roots electrodes (S1–S3) with rhizotomy.
OM: Bowel program times; QoL.

  1. Bowel program times were reduced from 5.4 hours per week to 2.0 hours.

  2. Subjects had an overall improvement in QoL.
Gstaltner et al. 2008;55 Austria
Downs & Black score = 11
Pre-Post
N = 11		 Population: Mean age: 46; Level of injury: n/a
Treatment: Implantation of sacral roots electrodes
OM: The Wexner Score for faecal continence; QoL.

  1. Five subjects had permanent implantations.

  2. Improved faecal continence, deliberate retention of faeces, and perianal sensitivity in all five subjects.

  3. Improved quality of life.
MacDonagh et al. 1990;54 UK
Downs & Black score=10
Pre-post
N=12		 Population: Mean age: 33, range 21–49; Level of injury: 10 thoracic, 2 cervical, all complete.
Treatment: Implanted Brindley-Finetech intradural sacral anterior root stimulator
OM: Full defecation

  1. Six patients achieved full defecation.

  2. Reduced time to complete defecation.

  3. All were free from constipation.
Binnie et al. 1991;51 UK
Downs & Black score=8
Prospective Controlled Trial
N=27		 Population: Group 1: Mean age: 29.1, range 22–38; non-SCI. Group 2: Mean age: 34.1, range 20–45; Level of injury C4-T10; Group 3: Mean age: 36.3, range 20–50; Level of injury: C5-T3.
Treatment: Brindley anterior sacral root stimulator implanted in Group 3.
OM: CTT, fecal water content, and frequency of defecation.

  1. No significant difference in CTT between all groups.

  2. Group 3 had a significant increase in defecation frequency versus group 2.
Johnston et al. 2005;56 USA
Downs & Black score = 14
Pre-post
N=3; however, only 2 had neurogenic bowel outcome measures and results presented only for 1		 Population: Age range: 17–21; Level of injury: T3–T8, complete.
Treatment: Stimulation of skeletal muscles for upright mobility. Two subjects also received extradural electrodes for bowel management.
OM: Rectum and anal sphincter pressures, quantity of stool passed, bowel evacuation time, and evacuation satisfaction.

  1. Stimulation at S3 increased anal sphincter and rectal pressure

  2. Daily use of stimulation significantly improved bowel management with increased frequency of defecation, decreased amount of time required for bowel evacuation, and improved satisfaction.

OM = Outcome measures; CTT = colonic transit times; n/a = information not available; QoL = quality of life