ReviewEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Predictive value of intraoperative bulbocavernosus reflex monitoring for postoperative voiding dysfunction after lumbosacral spine surgery: a systematic review and meta-analysis.
Review in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposePostoperative voiding dysfunction (POVD) is a significant complication of spinal dysraphism and lumbosacral spinal tumor resection. Conventional intraoperative neurophysiological monitoring modalities primarily assess the descending motor pathway and may not fully evaluate the integrity of the sacral reflex pathway. Intraoperative bulbocavernosus reflex (BCR) monitoring provides a real-time assessment of the sacral reflex arc's afferent and efferent pathways and may predict postoperative urinary function. However, its diagnostic performance and clinical utility remain incompletely defined. Therefore, this study aimed to evaluate the predictive value and diagnostic accuracy of intraoperative BCR monitoring for POVD in patients undergoing lumbosacral spine surgery.
methodsPubMed, Medline, Scopus, and Web of Science were searched comprehensively through March 2026. Random-effects models were used to pool BCR feasibility, diagnostic performance (sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV)), and the association between end-of-surgery BCR status and POVD. Leave-one-out sensitivity analyses and meta-regression were conducted to explore potential sources of heterogeneity.
resultsIntraoperative BCR monitoring was feasible with a success rate of 94%. BCR demonstrated moderate sensitivity of 62% (95% CI: 0.38-0.81) and high specificity of 99% (95% CI: 0.95-1.00) for predicting POVD. The pooled PPV, NPV, and accuracy were 93% (95% CI: 0.63-0.99), 94% (CI: 0.88-0.97), and 93% (CI: 0.87-0.96), respectively. End-of-surgery BCR maintenance was significantly associated with lower likelihood of POVD (OR: 0.02; 95% CI: 0.00-0.32; P = 0.0019). Conversely, BCR disappearance showed an imprecise trend towards higher likelihood of POVD (OR: 6.91; 95% CI: 0.87- 54.85; P = 0.0642).
conclusionIntraoperative BCR monitoring is feasible and may provide clinically useful predictive information for POVD after lumbosacral spine surgery. Its high specificity and NPV support its use as a part of a multimodal neuromonitoring protocol for assessing sacral pathway integrity. Further prospective studies are needed to validate its predictive performance and standardize monitoring protocols and outcome definitions.
Indexed as
Identifiers
42875591What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.