Clinical Anatomy of Cauda Equina and Lumbosacral Nerve Root

Abstract

Treatment of patients with neurogenic bladder dysfunction after spinal cord injure (SCI) is a challenge to the doctors all over the world till now. Although there are a lot of experimental new ways for recovery of neurogenic bladder dysfunction, it’s still far from clinical application [1]. Shanghai Changzheng hospital developed a new method for SCI patients’ bladder functional reestablishment with Achilles tendon reflex, which makes a certain use of somatic reflex under SCI level to control voiding [2]. The “tendon-CNS(central nerve system)-bladder” route is connected by ventral spinal roots cross anastomosis, then somatic motor impulses is passed to bladder smooth muscle through this reflex, so as to initiate voiding by stimulate Achilles tendon reflex [2]. As experimental study achieved satisfactory outcomes from dog SCI models [3, 4], anatomical study should be done before the step of more clinical applications. So the authors observed the component of cauda equina and lumbosacral nerve root to provide anatomical bases for the choice of proper spinal roots, the idea level for cross anastomosis and the identification of ventral spinal roots during the operation of bladder functional reconstruction with Achilles tendon reflex, knee reflex or lower abdominal reflex.