Table IXs.
Sacral reflexes in cauda equina and conus medullaris lesions.
| Reference | Objective | No. of patients | Sex | Test | Technique | Results | Evidence |
|---|---|---|---|---|---|---|---|
| Ertekin and Reel, 1976 | To determine the diagnostic value of the BCR in cauda equina lesions | 13 | M | BCR | Single electrical | Ab: 46%, ↑ Lat: 54% Ab: 47%, ↑ Lat: 27% |
Class 2 |
| Ertekin et al., 1979 | To determine the diagnostic value of the BCR in cauda equina or conus lesions | 40 | M | BCR | Single electrical | Ab: 100% in CLs, ↑ mean | Class 2 |
| Krane and Siroky, 1980 | To determine the diagnostic value of the BCR in cauda equina or conus lesions | 20 | M | BCR | Single electrical | sThr, t mean Lat Ab: 100% |
Class 2 |
| Awad et al., 1981 | To determine the diagnostic value of the PUR in cauda equina lesions | 3 | M | PUR | Single electrical | Ab: 100% in CLs, Ab: 40% in ILs | Class 2 |
| Blaivas et al., 1981 | To determine the diagnostic value of the BCR in conus lesions | 73 | 39M | PUR | Mechanical | Ab: 68%, ↑ Lat: 14% | Class 2 |
| Moon et al., 1993 | To determine the diagnostic value of the BCR in patients with conus lesions and ED | 35 | M | BCR | Single electrical | Ab: 55% (all CLs) | Class 2 |
| Schmid et al., 2003 | To assess the association between the BCR, level of lesion and EDs in cauda or conus lesions | 9 | M | BCR | Single electrical | Ab: 87% | Class 2 |
| Tas et al., 2007 | To assess the association between the BCR, level of lesion and EDs in cauda or conus lesions | 8 | 3M | BCR | Single electrical | Se: 81%; Se: 83%; Se: 81 % | Class 2 |
| Podnar, 2008 a | To determine the diagnostic value of the BCR, of EAS QEMG, and of their combination in chronic cauda equina or conus lesions | 52 | M | BCR | Single electrical; Double electrical; | Se: 94–96% | Class 2 |
| BCR+EAS Multi-MUP | Se: 81%; Se: 83%; | ||||||
| Podnar, 2008 b | To determine the diagnostic value of the BCR in chronic cauda equina or conus lesions | 53 | M | BCR | Se: 81 % | Class 2 | |
| Podnar, 2008 c | To compare three different techniques in chronic cauda equina or conus lesions | 52 | M | BCR | Single electrical; Double electrical; | Se: 70%; Se: 73%; Se: 73% | Class 2 |
| Combined methods | Se: 82% | ||||||
| Podnar, 2009 b | To determine the diagnostic value of clinical and neurophysiological evaluation of the BCR in chronic cauda equina or conus lesions | 53 | M | BCR | Single electrical; | Se: 81 %, Sp: 91%, PPV: 95%, NPV: 67%; | Class 2 |
| Double electrical; | Se: 83%, Sp: 90%, PPV: 96%, NPV: 68%; | ||||||
| Mechanical | Se: 81 %, Sp: 67%, PPV: 95%, NPV: 29% | ||||||
| Podnar, 2014 | To determine the diagnostic value of the BCR, of EAS QEMG, and of their combination in chronic cauda equina lesions | 24 | F | BCR | Single electrical; | Se: 92%, Sp: 67%, PPV: 52%, NPV: 95%; | Class 2 |
| Double electrical; | Se: 96%, Sp: 80%, PPV: 59%, NPV: 96%; | ||||||
| Mechanical | Se: 67% | ||||||
| BCR+EAS Multi-MUP | Se: 96–100%, Sp: 62–75%, PPV: 50–55%, NPV: 97–98% | ||||||
| Niu et al., 2010 | To determine the diagnostic value of the BCR in acute cauda syndrome | 9 | F | BCR | Single electrical; Double electrical; Mechanical | Ab/↑ Lat: 72% | Class 2 |
| Niu et al., 2015 | To determine the diagnostic value of the BCR in cauda equina syndrome | 53 | BCR | Single electrical | Ab: 3%, ↑ Lat: 82% | Class 2 |
Abbreviations: BCR=bulbocavernosus reflex; PUR=pudendal-urethral reflex; EDs=erectile dysfunctions; EAS=external anal sphincter muscle; QEMG=quantitative EMG; MUP=motor unit potential; M=male; F=female; Ab=absent response; Lat=latency; CLs=complete lesions; ILs=incomplete lesions; sThr=sensory threshold; Se=sensitivity; Sp=specificity; PPV=positive predictive value; NPV=negative predictive value.