{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T04:25:43Z","timestamp":1793679943121,"version":"4.5.1"},"reference-count":21,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the predictive value of intraoperative bulbocavernosus reflex (BCR) monitoring for postoperative bowel dysfunction (PBD) following conus medullaris and cauda equina tumor (CMCET) resection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 118 patients were analyzed. Neurogenic Bowel Dysfunction Scores &gt;6 at 1 month and 6 months postoperatively defined short- and long-term PBD. The amplitude reduction ratio (ARR) was calculated from bilateral BCR waveforms using the worst-side ARR for analysis. Multivariate logistic regression and ROC curve analysis determined independent predictors and optimal thresholds. Stratified 10-fold cross-validation confirmed threshold stability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients with short-term or long-term PBD had significantly higher ARRs than those without (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001 for both comparisons, Mann-Whitney U test). Furthermore, ARR emerged as the only independent predictor for either short-term (OR 1.287, 95% CI 1.018-1.627,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.035) or long-term PBD (OR 1.153, 95% CI 1.055-1.261,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.002). The threshold values of ARR for predicting short-term and long-term PBD were 59.6% (AUC = 0.991, 95% CI 0.974-1.000,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) and 63.6% (AUC = 0.988, 95% CI 0.971-1.000,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), respectively. Cross-validation confirmed these thresholds, with mean AUC values of 0.992 and 0.993 for short-term and long-term PBD, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The ARR of the intraoperative BCR waveform showed a high predictive value for PBD in patients with CMCET. We propose a 60% ARR reduction on either side of the BCR waveforms as an exploratory, hypothesis-generating early warning criterion for BCR monitoring during CMCET surgery, pending external validation in independent prospective cohorts before clinical implementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682261449739","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T16:39:48Z","timestamp":1778517588000},"page":"3961-3969","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Intraoperative Bulbocavernosus Reflex Monitoring for Predicting Bowel Function After Resection of Conus Medullaris and Cauda Equina Tumors"],"prefix":"10.1177","volume":"16","author":[{"given":"Ke","family":"Li","sequence":"first","affiliation":[{"name":"Beijing Neurosurgical Institute"},{"name":", Capital Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiajia","family":"Liu","sequence":"additional","affiliation":[{"name":"Beijing Neurosurgical Institute"},{"name":", Capital Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Yang","sequence":"additional","affiliation":[{"name":"Beijing Neurosurgical Institute"},{"name":", Capital Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiawei","family":"Shi","sequence":"additional","affiliation":[{"name":"Beijing Neurosurgical Institute"},{"name":", Capital Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingzhun","family":"Liang","sequence":"additional","affiliation":[{"name":"Beijing Neurosurgical Institute"},{"name":", Capital Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaorong","family":"Tao","sequence":"additional","affiliation":[{"name":"Beijing Neurosurgical Institute"},{"name":", Capital Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2893-9784","authenticated-orcid":false,"given":"Wenqing","family":"Jia","sequence":"additional","affiliation":[{"name":"Beijing Tiantan Hospital"},{"name":", Capital Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4165-3043","authenticated-orcid":false,"given":"Hui","family":"Qiao","sequence":"additional","affiliation":[{"name":"Beijing Neurosurgical Institute"},{"name":", Capital Medical University"},{"name":"Beijing Tiantan Hospital"},{"name":", Capital Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xing","family":"Fan","sequence":"additional","affiliation":[{"name":"Beijing Neurosurgical Institute"},{"name":", Capital Medical University"},{"name":"Beijing Tiantan Hospital"},{"name":", Capital Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,11]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.27390"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.3171\/2013.12.SPINE13668"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/PL00011940"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3181b34d16"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jos.2018.03.004"},{"key":"e_1_3_8_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2023.08.002"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-023-07837-8"},{"key":"e_1_3_8_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-015-2598-y"},{"issue":"1","key":"e_1_3_8_10_2","first-page":"88","article-title":"Intraoperative recording of the bulbocavernosus reflex","volume":"40","author":"Deletis V","year":"1997","unstructured":"Deletis V, Vodusek DB. Intraoperative recording of the bulbocavernosus reflex. Neurosurgery. 1997;40(1):88-92. discussion 92-3.","journal-title":"Neurosurgery"},{"key":"e_1_3_8_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2018.09.026"},{"key":"e_1_3_8_12_2","doi-asserted-by":"publisher","DOI":"10.3171\/2018.12.PEDS18535"},{"key":"e_1_3_8_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10877-021-00678-0"},{"key":"e_1_3_8_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2022.09.020"},{"key":"e_1_3_8_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2024.08.019"},{"key":"e_1_3_8_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2021.106165"},{"key":"e_1_3_8_17_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3101887"},{"issue":"6","key":"e_1_3_8_18_2","first-page":"909","article-title":"Intraoperative neuromonitoring in surgery of cauda equina and Conus medullaris tumors","volume":"29","author":"Taskiran E","year":"2019","unstructured":"Taskiran E, Ulu MO, Akcil EF, Hanci M. Intraoperative neuromonitoring in surgery of cauda equina and Conus medullaris tumors. Turk Neurosurg. 2019;29(6):909-914.","journal-title":"Turk Neurosurg"},{"key":"e_1_3_8_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-002-0582-3"},{"key":"e_1_3_8_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10877-018-0127-2"},{"issue":"3","key":"e_1_3_8_21_2","first-page":"e7233","article-title":"Bulbocavernosus reflex monitoring during intramedullary Conus tumor surgery","volume":"12","author":"Overzet K","year":"2020","unstructured":"Overzet K, Jahangiri FR, Funk R. Bulbocavernosus reflex monitoring during intramedullary Conus tumor surgery. 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