Abstract
Introduction Sacrospinal anomalies that may accompany anorectal malformations may cause fecal
and urinary incontinence despite proper anomaly treatment. The sacral ratio has been
suggested in the determination of both the prognosis in terms of incontinence and
the need for further examination for sacrospinal anomalies. The normal and clinically
decisive values of sacral ratio are given differently in publications. We aimed to
determine the distribution of the sacral ratio in children under 12 months and to
develop the sacral ratio percentile card that will enable one to give an age-independent
parametric result in clinical evaluations.
Materials and Methods The files of patients under 1 year of age who had anteroposterior direct radiography
including pelvis were reviewed retrospectively. Sacral ratio was studied for 360 patients,
30 patients per month. Percentile card was developed with LMS software and reference
values were used as 1, 2, 3, 4, and 10%.
Results The lowest sacral ratio value was 0.514 and the highest value was 0.936. There was
no statistical difference between the mean sacral ratio of the cases when they were
classified on a monthly basis (p = 0.191). Low percentile values were found slightly different at first 4 months of
age.
Conclusion Although the mean of sacral ratio does not change significantly during the first
year of life, values that are considered pathological for patients are within different
percentile limits depending on age. Instead of using sacral ratio with some clinically
decisive values, we think that parametric evaluation with the help of the percentile
card will increase its clinical value.
Keywords
anorectal malformations - child - incontinence - sacral ratio - tethered cord
