dr rollay dorsal column stimulator trial

Dr rollay dorsal column stimulator trial trial#

Participants' bladder function will be measured before, and for six months after, the intervention, and they will be asked to complete a diary about their bladder and bowel routines, as well as questionnaires about their quality of life.Īt the end of the trial, the volunteers will be able to choose to have their devices removed or to keep them. They will be asked to use this at home for six weeks, and will also be given some bladder training exercises to do.

Dr rollay dorsal column stimulator trial trial#

Those who respond well to a one-day trial with epidural stimulation, where electrodes will be implanted close to the spinal cord, but the device and wires remain external to the body, will be offered a fully implantable epidural stimulator, controllable via a smartphone app. The team will recruit volunteers who suffered an SCI more than 12 months previously. Patients also reported benefits to their bladder and bowel function, even though the electrodes were not optimally positioned to target these organs. Stimulation targeting the nerves that control leg muscles has enabled people to move their otherwise-paralysed limbs. It is not routinely used after SCI, but several trials are currently underway in this population, with impressive results. This kind of epidural stimulation is currently used in the NHS to treat long-term back and leg pain. The electrodes apply small electrical pulses to activate nerves, and can be positioned to target all of the nerves that control the bladder and bowel. This involves the implantation of electrodes close to the spinal cord, with the stimulator device and wires implanted around the abdomen. In this project, the team will test whether they can achieve a similar effect using an implantable device called an epidural stimulator. “ However the devices used did not work well when people tried to use them at home – the electrodes did not stay in place well, and the device and wires were found to be inconvenient for daily use.” We already know that if we apply electrical stimulation to one of these nerves, we can switch off an unwanted bladder contraction, giving the individual more time to find a toilet,” explains Dr Duffell. ‍ “While the bladder is a simple organ, its control system is highly complex, involving interactions between several different nerves, the brain and the spinal cord. Electrical stimulation to improve bladder control after spinal cord injury Improving bladder and bowel management is a priority among people living with SCI. These existing management techniques are far from ideal as around half of people living with SCI continue to experience incontinence, constipation and infections, which can lead to much more serious complications and potentially death. Medication is also usually prescribed, but can cause uncomfortable side effects. People with SCI usually manage their bladders with a catheter, which may need changing several times a day. Bladders also tend to become overactive after SCI, meaning that the bladder may contract frequently, before it is full, with little or no warning, and individuals often do not have enough time to find a toilet. People with SCI have reduced awareness of their bladder being full, and reflexes can cause it to empty involuntarily. The bladder is a simple organ that expands to store urine, and contracts to empty it under voluntary control at a socially convenient time. The functions of organs such as the bladder and bowel are also affected, which severely impacts quality of life. As a result, people living with spinal cord injury (SCI) have limited or no ability to feel or move their affected limbs. BackgroundĪn injury to the spinal cord causes an interruption or complete block of the normal messages that pass between the brain and parts of the body.

In this project, a collaborative, multidisciplinary team lead by Dr Lynsey Duffell at University College London will recruit spinal cord injured volunteers to a trial that will use electrical stimulation of the spinal cord to improve bladder control.įollowing rigorous assessment as part of our competitive grant round, this project was recommended for its strong potential to benefit patients affected by a distressing problem. People will have limited or no ability to feel or move limbs below the level of the injury, and the functions of organs such as the bladder and bowel are also affected, which can be very distressing.Įxisting techniques for managing bladder problems are inadequate, and improving bladder management is a priority for those living with spinal cord injury.

The day-to-day impact of a spinal cord injury varies from person to person, depending on the nature, severity and location of the injury. It is estimated that there are around 50,000 people in the UK living with the effects of a spinal cord injury, and around 1,000 new spinal cord injuries each year.