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.
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.
Authors: Giorgia Totonelli; Raffaella Messina; Francesco Morini; Giovanni Mosiello; Paolo Palma; Marianna Scuglia; Barbara D Iacobelli; Pietro Bagolan Journal: Pediatr Surg Int Date: 2017-06-10 Impact factor: 1.827
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Authors: A Suppiej; L Dal Zotto; A Cappellari; A Traverso; M Castagnetti; P Drigo; P Midrio Journal: Pediatr Surg Int Date: 2009-10 Impact factor: 1.827
Authors: Giorgia Totonelli; Francesco Morini; Vincenzo Davide Catania; Paolo Maria Schingo; Giovanni Mosiello; Paolo Palma; Barbara Daniela Iacobelli; Pietro Bagolan Journal: Pediatr Surg Int Date: 2016-07-02 Impact factor: 1.827
Authors: María Fanjul; I Samuk; P Bagolan; E Leva; C Sloots; C Giné; D Aminoff; P Midrio Journal: Pediatr Surg Int Date: 2017-07-03 Impact factor: 1.827