Relationship between Preoperative Neuroradiological Findings and Intraoperative Bulbocavernosus Reflex Amplitude in Patients with Intradural Extramedullary Tumors

Sugiyama, Kunio; Harada, Naoyuki; Kondo, Kosuke; Wada, Akihito; Takahashi, Hiroshi; Sugo, Nobuo

doi:10.2176/nmc.oa.2020-0425

Cited by 5 publications

(1 citation statement)

References 31 publications

(61 reference statements)

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“…During spinal cord surgery, the most important influencing factor of the BCR might be the operation [ 55 , 56 ]. Specifically, the severity of the preoperative symptoms related to the urinary system has the greatest impact on the changes in the waveform of BCR during surgery [ 57 ]. There are currently no standard warning criteria for BCR.…”

Section: Introductionmentioning

confidence: 99%

The role of intraoperative neurophysiological monitoring in intramedullary spinal cord tumor surgery

Liu,

Ma,

et al. 2023

Chin Neurosurg Jl

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Intramedullary tumors are a class of central nervous system tumors with an incidence of 2 to 4%. As they are located very deep and frequently cause postoperative neurological complications, surgical resection is difficult. In recent years, many surgeons have performed electrophysiological monitoring to effectively reduce the occurrence of postoperative neurological complications. Modern electrophysiological monitoring technology has advanced considerably, leading to the development of many monitoring methods, such as SSEPs, MEPs, DCM, and EMG, to monitor intramedullary tumors. However, electrophysiological monitoring in tumor resection is still being studied. In this article, we discussed the different monitoring methods and their role in monitoring intramedullary tumors by reviewing previous studies. Intratumorally tumors need to be monitored for a summary of the condition of the patient. Only by using various monitoring methods flexibly and through clear communication between surgeons and neurophysiological experts can good decisions be made during surgery and positive surgical results be achieved.

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Section: Introductionmentioning

confidence: 99%

The role of intraoperative neurophysiological monitoring in intramedullary spinal cord tumor surgery

Liu,

Ma,

et al. 2023

Chin Neurosurg Jl

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The diagnostic accuracy of neuromonitoring for detecting postoperative bowel and bladder dysfunction in spinal oncology surgery: a case series

Silverstein,

D’Amico,

Mehta

et al. 2024

J Neurooncol

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Intraoperative Monitoring of the External Urethral Sphincter Reflex: A Novel Adjunct to Bulbocavernosus Reflex Neuromonitoring for Protecting the Sacral Neural Pathways Responsible for Urination, Defecation and Sexual Function

Silverstein,

Block,

Olmsted

et al. 2023

Journal of Clinical Neurophysiology

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Purpose: Intraoperative bulbocavernosus reflex neuromonitoring has been utilized to protect bowel, bladder, and sexual function, providing a continuous functional assessment of the somatic sacral nervous system during surgeries where it is at risk. Bulbocavernosus reflex data may also provide additional functional insight, including an evaluation for spinal shock, distinguishing upper versus lower motor neuron injury (conus vs. cauda syndromes) and prognosis for postoperative bowel and bladder function. Continuous intraoperative bulbocavernosus reflex monitoring has been utilized to provide the surgeon with an ongoing functional assessment of the anatomical elements involved in the S2–S4 mediated reflex arc including the conus, cauda equina and pudendal nerves. Intraoperative bulbocavernosus reflex monitoring typically includes the electrical activation of the dorsal nerves of the genitals to initiate the afferent component of the reflex, followed by recording the resulting muscle response using needle electromyography recordings from the external anal sphincter. Methods: Herein we describe a complementary and novel technique that includes recording electromyography responses from the external urethral sphincter to monitor the external urethral sphincter reflex. Specialized foley catheters embedded with recording electrodes have recently become commercially available that provide the ability to perform intraoperative external urethral sphincter muscle recordings. Results: We describe technical details and the potential utility of incorporating external urethral sphincter reflex recordings into existing sacral neuromonitoring paradigms to provide redundant yet complementary data streams. Conclusions: We present two illustrative neurosurgical oncology cases to demonstrate the utility of the external urethral sphincter reflex technique in the setting of the necessary surgical sacrifice of sacral nerve roots.

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Relationship between Preoperative Neuroradiological Findings and Intraoperative Bulbocavernosus Reflex Amplitude in Patients with Intradural Extramedullary Tumors

Cited by 5 publications

References 31 publications

The role of intraoperative neurophysiological monitoring in intramedullary spinal cord tumor surgery

The role of intraoperative neurophysiological monitoring in intramedullary spinal cord tumor surgery

The diagnostic accuracy of neuromonitoring for detecting postoperative bowel and bladder dysfunction in spinal oncology surgery: a case series

Intraoperative Monitoring of the External Urethral Sphincter Reflex: A Novel Adjunct to Bulbocavernosus Reflex Neuromonitoring for Protecting the Sacral Neural Pathways Responsible for Urination, Defecation and Sexual Function

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