Spinal cord anomalies in children with anorectal malformations: a retrospective cohort study

Pediatr Surg Int. 2023 Mar 19;39(1):153. doi: 10.1007/s00383-023-05440-y.

Abstract

Purpose: First, to assess the number of spinal cord anomalies (SCA), specifically tethered spinal cord (TSC) in patients with anorectal malformations (ARM), identified with spinal cord imaging (i.e. spinal cord US and/or MRI). Second, to report outcomes after TSC treatment.

Methods: A retrospective mono-center study was performed. All ARM patients born between January 2000 and December 2021 were included. Screening for SCA consisted of spinal cord US and/or MRI. Radiology reports were scored on presence of SCA. Data were presented with descriptive statistics.

Results: In total, 254 patients were eligible for inclusion, of whom 234 (92.1%) underwent spinal cord imaging. In total, 52 (22.2%) patients had a SCA, diagnosed with US (n = 20, 38.5%), MRI (n = 10, 19.2%), or both US and MRI (n = 22, 42.3%), of whom 12 (23.5%) with simple, 27 (52.7%) intermediate, and 12 (23.5%) complex ARM types. TSC was identified in 19 patients (8.1%), of whom 4 (21.1%) underwent uncomplicated neurosurgical intervention.

Conclusions: SCA were present in 22% of ARM patients both in simple, as well as more complex ARM types. TSC was present in 19 patients with SCA, of whom 4 underwent uncomplicated neurosurgical intervention. Therefore, screening for SCA seems to be important for all ARM patients, regardless of ARM type.

Level of evidence: Level III.

Keywords: Anorectal malformations; Children; Spinal cord anomalies; Tethered spinal cord; Untethering surgery.

MeSH terms

  • Abnormalities, Multiple*
  • Anorectal Malformations* / epidemiology
  • Child
  • Humans
  • Magnetic Resonance Imaging
  • Retrospective Studies
  • Spinal Cord / abnormalities
  • Spinal Cord / diagnostic imaging