原文
http://housecall.beaumonthospitals.com/innovations-nerve-rewiring
Modern Medical Marvels
December 1, 2008
Billy Kraser will never forget his ninth birthday. On April 3, he went to Beaumont Hospital in Royal Oak and had a life-changing surgery that will hopefully allow him to use the bathroom on his own.
When Billy was a 14-day-old embryo, his spinal cord developed a hole in it that caused spina bifida, a common birth defect. "Spina bifida is a malformation that happened during the first month of mypregnancy with Billy," says his mom, Janice Kraser. "The cells didn't complete their mission when developing. The major problem for kids like Billy is typically bowel and bladder issues."
For nine years, Billy had a catheter inserted up to five times a day to empty his bladder. "Any time you cath him, you're introducing new bacteria into his body, putting him at a higher risk for kidney and urinary tract infections," explains Janice, an open-heart surgery nurse in Scranton, Penn. Using the catheter required the family to be in a clean environment every couple of hours. So, while the catheter was helping Billy, it was also tethering him to his home.
But in February, Janice was online with a spina bifida support group when a friend told her about a research study at Beaumont that could give Billy more control over his bladder and bowels. The research at Beaumont uses a spinal surgery pioneered in China to redirect nerves from the leg to the bladder to gain better control of urination. Beaumont is the only U.S. hospital performing this surgery, and patients have traveled from as far as Utah for it. The Chinese doctor who developed the surgery, Chuan-Guo Xiao, M.D., reports an almost 90-percent success rate and an average time for results of 12 to 24 months after surgery.
Kenneth Peters, M.D., chairman of Urology at Beaumont, Royal Oak and Dr. Xiao removed a piece of Billy's vertebrae that controls part of the thigh muscle. "The risks were inconsequential compared to the risk for kidney disease," says Janice. "Billy was part of the decision. He was scared and didn't want to have another surgery, but in the end, he saw the good in it."
"We got to the hospital and they did surgery on April 3, my birthday," remembers Billy, the youngest of four children. "When the surgery was over, my mom gave me a green dragon stuffed animal as a present. It's pretty cool."
Janice says, "The most amazing part of the procedure was afterward, when we could see the bladder contractions. The doctors were able to take something out of its normal environment and make it work somewhere else."
Billy's newly re-wired nerve grows about one millimeter a day. He's able to urinate on demand, just by scratching or pinching his thigh, which stimulates the nerve and signals the bladder to empty. Billy's working on retraining his bladder muscles and is not able to empty completely yet, but he's making progress. "I'm glad I had the surgery because I can finally do what I could never do before: pee in the toilet," he says. "I can also do stuff easier now without having a problem worrying about having an accident."
Billy has a few more years before he'll know if the surgery was a success. Janice looks at the bigger picture: "If it doesn't end up working for Billy, it's better to try and fail and help someone else in the future than to not have done it at all. But, we would do it again, without hesitation."
