Continuous low-frequency pelvic nerve stimulation for therapy of intractable gluteal/heel pressure ulcers in persons with spinal cord injury.

STUDY

DESIGN

Case report.

OBJECTIVES

Pressure ulcers (PUs) affect many spinal cord-injured individuals and can result in serious life-threatening complications including infections and gangrene. Treatment is lengthy and extremely expensive due to recurrent and prolonged hospitalization and multiple surgeries. Consequently, for both medical and economic reasons, intensive efforts in prophylaxis and new effective therapeutic options are mandatory. This report presents the positive effects of pelvic nerve stimulation on the healing of gluteal and heel PUs.

SETTING

Hospital in Zürich/CH.

METHODS

Five patients with spinal cord injuries with PUs underwent continuous low-frequency electrostimulation (10 Hz) of the sciatic and femoral nerves by means of laparoscopic implantation of a neuroprosthesis via the LION procedure. This procedure is primarily performed in persons with chronic spinal cord injuries to facilitate voluntary electrically assisted walking function. Evaluations included quadriceps muscle thickness, regional skin temperature, and subjective healing reports. Evaluations were conducted at baseline and after three months of stimulation.

RESULTS

The LION procedure significantly increased the healing process of gluteal (n = 3) and heel (n = 2) PUs in 5 patients. Besides cutaneous vasodilation, there was a significant increase in gluteal/legs muscle mass on both sides. All ulcers completely healed within three months.

CONCLUSIONS

Pelvic somatic nerve stimulation showed promise as a treatment for pressure ulcers in patients with spinal cord injuries by enabling gluteal pressure relief, peripheral vasodilation, and muscle building.