Novel repair strategies to restore bladder function following cauda equina/conus medullaris injuries.
Trauma to the thoracolumbar junction or lumbosacral spine may result in a conus medullaris or cauda equina syndrome. In both conditions, symptoms typically include paraparesis or paraplegia, sensory impairment, pain, as well as bladder, bowel, and sexual dysfunctions. We present in this review a series of neural repair strategies that have been developed to address the unique features and challenges of subjects with a conus medullaris or cauda equina syndrome. We address, in particular, neural repair strategies that may have a translational research potential to restore bladder function. Recent animal injury models have suggested that a progressive retrograde death of both autonomic and motor neurons may contribute to the neurological deficits in subjects with conus medullaris and cauda equina injuries. For subjects with acute injuries, we present novel strategies to promote neuroprotection, axonal regeneration, and functional reinnervation of the lower urinary tract. For subjects with chronic injuries, we discuss new approaches to replace lost autonomic and motor neurons. A brief discussion on a variety of outcome measures that may be suitable to evaluate the function of the lower urinary tract in rodent neural repair models is also provided.
Hoang
Thao X
TX
Department of Neurology, David Geffen School of Medicine at University of California Los Angeles, 710 Westwood Plaza, Los Angeles, CA 90095-1769, USA.
Havton
Leif A
LA
D000818:Animals; D001339:Autonomic Fibers, Preganglionic / Q000473:pathology / Q000502:physiology; D002420:Cauda Equina / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology; D009414:Nerve Growth Factors / Q000378:metabolism; D009416:Nerve Regeneration / Q000502:physiology*; D019001:Nitric Oxide Synthase / Q000378:metabolism; D017475:Receptors, Nerve Growth Factor / Q000378:metabolism; D020127:Recovery of Function; D012447:Sacrum / Q000473:pathology; D013116:Spinal Cord / Q000033:anatomy & histology / Q000473:pathology / Q000502:physiology / Q000601:surgery; D013119:Spinal Cord Injuries / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D013904:Thoracic Vertebrae / Q000473:pathology; D001743:Urinary Bladder / Q000033:anatomy & histology / Q000294:innervation* / Q000502:physiology*; D001745:Urinary Bladder Diseases / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D014551:Urinary Tract / Q000294:innervation
D009414:Nerve Growth Factors; D017475:Receptors, Nerve Growth Factor; D019001:Nitric Oxide Synthase