2005, Number 2
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ABSTRACTComplete medullar section produces severe functional changes, with an inability to move that forces patients to remain in bed, favoring the formation of pressure sores, infection and malnutrition. Different procedures to repair the damage have been carried out, such as suture of the sectioned medulla; intersegmentary anastomoses of the nerve roots, or anastomoses of outlying nerve to the lumbar plexus, without satisfactory results. Turbes carried out studies in dogs with medullar section, in which anastomoses of outlying intercostal nerve was made in the medulla in the immediate distal part closest to the section, obtaining results in mobility and axonal regeneration. We carried out a controlled study in eight patients with complete medullar section; in Group I, with four patients that were not operated on, spontaneous recovery went from one to two levels below the lesion, and in Group II, with four patients, intercostal nerve flap was implanted to the portion immediately below to the lesion, with electrostimulation, recovering sensibility from 6 to 9 dermatomes; the function of the abdomen, hip, thigh and leg muscles. Three patients were able to have an acceptable control to urinate and defecate, and one of them was able to have erections and sustain sexual intercourse. The procedure in patients with complete medullar section has enabled recovery of up to 9 levels of sensitivity to the lesion site, recovery of function in some muscles and in some of them, neurovegetative functions; therefore this procedure is very useful in patients that suffer medullar section.
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