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Surgical Aspects of the Possover LION Procedure
Table 3: Postoperative CT controls measures in 273 patients. Spinal Cord 2009;47(7):555–560. DOI:
10.1038/sc.2008.162.
Patient CT scan 10 days CT scan 8 weeks 4. Fawcett JW, Curt A, Steeves JD, et al. Guidelines for the conduct of
No. after operation after operation
clinical trials for spinal cord injury as developed by the ICCP panel:
9 No dislocation No dislocations spontaneous recovery after spinal cord injury and statistical power
10 No dislocation Missing needed for therapeutic clinical trials. Spinal Cord. 2007;45(3):190–205.
11 Left femoral lead Left + Right femoral leads dislocated DOI: 10.1038/sj.sc.3102007.
dislocated from nerves 5. Elmgreen SB, Krogh S, Løve US, et al. [Neuromodulation in spinal cord
injury rehabilitation]. Ugeskr Laeger 2019;181(26).
12 No dislocation Missing 6. Possover M. A new technique of laparoscopic implantation of
13 No dislocation Slight dislocation of three electrodes, stimulation electrode to the pudendal nerve for treatment of
still in contact with nerves refractory fecal incontinence and/or overactive bladder with urinary
14 No dislocation No dislocation incontinence. J Minim Invasive Gynecol 2014;21(5):729. DOI: 10.1016/j.
jmig.2014.02.003.
15 Dislocation of After surgical correction, no 7. Possover M. A novel implantation technique for pudendal nerve
right femoral and electrodes dislocated stimulation for treatment of overactive bladder and urgency
sciatic electrodes incontinence. J Minim Invasive Gynecol 2014;21(5):888–892.
16 No dislocation Slight dislocation of the right femoral DOI: 10.1016/j.jmig.2014.03.026.
lead, still in contact with nerve 8. Possover M. The LION procedure to the pelvic nerves for treatment
of urinary and faecal disorders. Surg Technol Int 2014;24:225–230.
9. Possover M. Recovery of sensory and supraspinal control of leg
movement in people with chronic paraplegia: a case series. Arch Phys
conclusIon Med Rehabil 2014;95(4):610–614. DOI: 10.1016/j.apmr.2013.10.030.
10. Possover M, Schurch B, Henle KP. New strategies of pelvic nerves
The Possover LION procedure may be performed safely in patients stimulation for recovery of pelvic visceral functions and locomotion
with thoracolumbar traumatic SCI. The election of suitable in paraplegics. Neurourol Urodyn 2010;29(8):1433–1438. DOI: 10.1002/
patients for the operation should include a specialist team of nau.20897.
skilled neurologists, neurorehabilitation physiotherapists, and 11. Possover M. The LION procedure to the pelvic nerves for recovery
highly experienced pelvic surgeons. We recommend that the of locomotion in 18 spinal cord injured peoples - a case series. Surg
Technol Int 2016;29:19–25.
Possover LION procedure is performed only at expert centers 12. Angeli CA, Boakye M, Morton RA, et al. Recovery of over-ground
with experienced pelvic surgeons and a team of neurologists and walking after chronic motor complete spinal cord injury. N Engl J
physiotherapists dedicated to patient training and follow-up. The Med 2018;379(13):1244–1250. DOI: 10.1056/NEJMoa1803588.
International Society of Neuropelveology (ISON) offers theoretical 13. Bendersky D, Yampolsky C. Is spinal cord stimulation safe? A review
and practical training in the LION procedure, and we highly of its complications. World Neurosurg 2014;82(6):1359–1368. DOI:
recommend certification by this Society before undertaking the 10.1016/j.wneu.2013.06.012.
Possover LION procedure. 14. Kleiber JC, Marlier B, Bannwarth M, et al. Is spinal cord stimulation safe?
A review of 13 years of implantations and complications. Rev Neurol
(Paris) 2016;172(11):689–695. DOI: 10.1016/j.neurol.2016.09.003.
AcknowledgMents 15. Döring M, Richter S, Hindricks G. The diagnosis and treatment of
The study was supported by, and received financial support from, pacemaker-associated infection. Dtsch Arztebl Int 2018;115(26):
445–452. DOI: 10.3238/arztebl.2018.0445.
the Viborg Regional Hospital and the Central Denmark Region 16. Eldabe S, Buchser E, Duarte RV. Complications of spinal cord
Health Research Fund. stimulation and peripheral nerve stimulation techniques: a review of
the literature. Pain Med 2016;17(2):325–336. DOI: 10.1093/pm/pnv025.
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analysis of use of serum C-reactive protein levels to predict

Uffe S Løve https://orcid.org/0000-0002-2409-0499 anastomotic leak after colorectal surgery. Br J Surg 2014;101(4):
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80 World Journal of Laparoscopic Surgery, Volume 14 Issue 2 (May–August 2021)