Eur J Pediatr Surg 2007; 17(6): 408-411
DOI: 10.1055/s-2007-989277
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Evaluation and Treatment for Spinal Cord Tethering in Patients with Anorectal Malformations

K. Uchida1 , M. Inoue1 , T. Matsubara2 , K. Otake1 , Y. Koike1 , Y. Okugawa1 , A. Kawamoto1 , C. Miki1 , M. Kusunoki1
  • 1Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
  • 2Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
Further Information

Publication History

received May 14, 2007

accepted after revision July 2, 2007

Publication Date:
11 December 2007 (online)

Abstract

Background: It has recently been recognized that there is a close relationship between spinal cord tethering (SCT) and congenital anorectal malformation (ARM). Patients and Methods: We evaluated spinal MRI examinations of 28 patients with ARM (14 boys and 14 girls) aged 5 months to 9 years. All patients diagnosed with SCT subsequently underwent operation. Patients were divided into high and low type ARM groups. We reviewed the relationship between SCT and ARM, and evaluated the untethering surgery. Results: We evaluated 14 boys (high, 9; low, 5) and 14 girls (high, 4; low, 10). Of these 28 patients, 13 had SCT on MRI. Five out of 13 patients with high type ARM and 8 out of 15 patients with low type ARM had SCT. Seven out of 10 girls with low type ARM had SCT. Ten of these 13 patients with SCT experienced bowel/urological/orthopedic symptoms. SCT symptoms progressed prior to operation in the 2 patients who underwent untethering surgery a few years after their initial MRI examination. Postoperatively, orthopedic symptoms disappeared completely in all patients, but other symptoms did not. Conclusions: Based on the results of this study, we recommend routine MRI examination of patients with ARM and early untethering surgery in cases with SCT.

References

M.D. Keiichi Uchida

Department of Gastrointestinal and Pediatric Surgery
Mie University Graduate School of Medicine

Edobashi 2-174

Tsu, Mie 514-8507

Japan

Email: [email protected]