Anatomical feasibility of performing intercostal and ilioinguinal nerve to pelvic nerve transfer: a possible technique to restore lower urinary tract innervation Laboratory investigation

作者：Brown Justin M; Barbe Mary F; Albo Michael E; Lai H Henry; Ruggieri Michael R^*

来源：Journal of Neurosurgery-Spine, 2012, 17(4): 357-362.

DOI：10.3171/2012.7.SPINE12214

• intercostal nerve
• ilioinguinal nerve
• pelvic nerve
• bladder
• cadaver dissection
• anatomy

Object. Nerve transfers are effective for restoring control to paralyzed somatic muscle groups and, recently, even to denervated detrusor muscle in a canine model. A pilot project was performed in cadavers to examine the feasibility of transferring somatic nerves to vesical branches of the pelvic nerve as a method for potentially restoring innervation to control the detrusor muscle in humans. %26lt;br%26gt;Methods. Eleven cadavers were dissected bilaterally to expose intercostal, ilioinguinal, and iliohypogastric nerves, along with vesical branches of the pelvic nerve. Ease of access and ability to transfer the former 3 nerves to the pelvic vesical nerves were assessed, as were nerve cross-sectional areas. %26lt;br%26gt;Results. The pelvic vesical nerves were accessed at the base of the bladder, inferior to the ureter and accompanied by inferior vesical vessels. The T-11 and T-12 intercostal nerves were too short for transfer to the pelvic vesical nerves without grafting. Ilioinguinal and iliohypogastric nerves (L-1 origin) were identified retroperitoneally and, with full dissection, were easily transferred to the pelvic vesical nerves intraabdominally. The mean cross-sectional area of the dominant pelvic vesical branch was 2.60 +/- 0.169 mm(2); ilioinguinal and iliohypogastric branches at the suggested transection site were 2.38 +/- 0.32 mm(2) (the means are expressed +/- SEM). %26lt;br%26gt;Conclusions. Use of the ilioinguinal or iliohypogastric nerves for heterotopic transfer to pelvic vesical nerves is surgically feasible, based on anatomical location and cross-sectional areas. (http://thejns.org/doi/abs/10.3171/2012.7.SPINE12214)

• 出版日期2012-10