The neurovisceral and electrodiagnostic evaluation of patients with thoracic spinal cord injury.

We studied nine patients with complete thoracic spinal cord injury in order to investigate distal electrophysiologic and end organ function. Studies included motor and sensory nerve conduction velocities, spinal and cortical somatosensory evoked responses, bulbocavernosus reflex responses, cystometry and colonic compliance, motor and myoelectrical activity. These studies confirmed an intact peripheral nervous system, as well as normal nerve root, cauda equina, conus medullaris and distal spinal cord function. Cystometry demonstrated decreased bladder capacity and inability to suppress detrusor contractions. Colonic compliance was greatly reduced, compared to control subjects. While basal colonic motor and myoelectrical activity was normal, these spinal cord injury patients failed to demonstrate the postprandial increase in colonic motor and myoelectric activity seen in normal subjects. These tests allow the clinician to define and document the extent of neuronal injury distal to a transverse myelopathy and to evaluate visceral end organ function.