The Urodynamic Study in Vertebral Disorders with Nerve Root Compression

Sohng, Inho; Kim, Hyung Jee; Kim, Myung Ho

Abstract

PURPOSE: Nerve root compression from spinal stenosis or herniated intervertebral disc(HIVD) may affect bladder function by the disease itself, operation or inappropriate general postoperative care. Preoperative urodynamic study seems to be needed for differential diagnosis of postoperative bladder dysfunction.
MATERIALS AND METHODS
Thirty three patients diagnosed as nerve root compression were analysed for urodynamic features prospectively and classified into type I(hyporeflexic, hyposensitive, normal sphincter and hypocontractile, high compliance), type II(hyperreflexic, hypersensitive, normal sphincter and hypocontractile, low compliance), type III(hyperreflexic, hypersensitive, normal sphincter and hypercontractile, low compliance) and normal. Correlation with voiding symptoms, duration of the disease and urodynamic findings was evaluated.
RESULTS
The mean age of patients was 56.2 years(29-80 years old), including 21 men and 12 women. Among thirty three patients, 21 had spinal stenosis and twelve patients were diagnosed as HIVD. Urodynamically, there were 16 cases(48.5%) showing type II, 6 cases(18.2%) for type I and 2 cases(6%) for type III. Normal finding was shown in 9 cases(27.3%). No significant difference was shown in mean duration of disease and in urodynamic findings. Patients with voiding symptoms or abnormal urodynamic finding were 20 cases(60.6%) and 24 cases(72.7%), respectively. Among thirteen patients without voiding symptoms, eight patients(61.5%) had abnormal urodynamic findings.
CONCLUSIONS
Voiding symptoms and urodynamic findings in patients with nerve root compression were various. Because there is no consistent pattern of dysfunction with any type of nerve root compression disease, preoperative urodynamic study seems to the cornerstone for rational therapy and gives the exact information of bladder function to orthopedic operator.