To investigate the relationships between the video-urodynamic findings, pelvic floor electrophysiological characteristics and the level and degree of spinal cord injury (SCI).

This retrospective review analyzed the clinical records, video-urodynamic and pelvic floor electrophysiological data of 647 patients with traumatic spinal cord and out of spinal shock. Patients were classified based on American Spinal Injury Association (ASIA) Impairment Scale (AIS) and video-urodynamic findings. The thoracic injury was divided to the level of T1-9 and T10-12 because the sympathetic innervation of the low urinary tract originates the T0-L2.

Of the 647 patients, the proportion of cervical, T1-9 thoracic, T10-12 thoracic and lumbar spinal cord injury and conical caudal injury were 29.3% (190), 21% (136), 28.1% (182), 6.2% (40) and 15.4% (99). Detrusor overactivity (DO) with or without detrusor sphincter dyssynergia (DSD) was found in 79.5% (151/190), 61% (83/136), 35.2% (64/182), 35% (14/40) and 19.2% (19/99) of patients with cervical, thoracic (T1-9), thoracic (T10-12), lumbar and conical caudal injury respectively. Only one patient with incomplete lumbar injury had normal bladder. The other patients manifested detrusor underactivity (DU). Bulbocavernosus reflex (BCR) was found in 95.3% (191/190), 68.4% (93/136), 52.2% (95/182), 60% (24/40) and 45.5% (45/99) of patients with cervical, thoracic (T1-9), thoracic (T10-12), lumbar and conical caudal injury. However, The manifestation of BCR also related to the degree of SCI. Sensory evoked potential (SEP) was presented in 9 complete SCI patients and 70 incomplete SCI patients.

Both DO and DU are found not only in the patients with cervical and thoracic SCI but also in ones with lumbar and conical caudal SCI; SPE is existed in complete SCI patients.

This study indicated a significant correlation between the level of SCI and the video-urodynamic characteristics, but clinical examination cannot be alone to predict the type of bladder function after SCI and urodynamic testing is necessary. Additionally, the manifestation of BCR and SEP are associated with the level and degree of SCI.