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

Abstract

Based on the results of this study, we recommend routine MRI examination of patients with ARM and early untethering surgery in cases with SCT.

Spinal dysraphism with anorectal malformation: lumbosacral magnetic resonance imaging evaluation of 120 patients

“…The benefit of detethering surgery is also controversial. The results of many studies suggest that neurosurgical release of tethered spinal cord has a beneficial effect on urinary [9,12,38,39], orthopedic [9], and bowel function [39]. Evidence of such a beneficial effect was not clearly observed in bowel function in the present study.…”

“…Another important aspect of spinal cord tethering is that it is not a static condition, with several reports of progressive neurologic deficit in children with tethered cord syndrome [38,41]. The present study includes one patient who showed newly developed tethered cord syndrome based on the results of serial MRI, which is similar to the previous report [9]. These patients have an anatomically stable but growing lipomatous mass because of increased lipogenesis within the spinal canal during the early years of life.…”

“…In addition to the sacral bony abnormalities, evaluation of spinal dysraphism should include abnormalities of the spinal cord itself because so-called spinal cord tethering is associated with various orthopedic [8][9][10], urologic [8,[11][12][13], and gastrointestinal problems [14,15]. In the present study, the The mean SR in patients who underwent detethering surgery was significantly lower than in patients who did not undergo detethering surgery.…”

Screening and Treatment of Tethered Spinal Cord in Anorectal Malformation Patients

“…6,[13][14][15][16][17][18] This can best be explained by the diagnostic methods used. In the studies that detected a higher prevalence, up to 35 to 46%, 6,18 patients were screened for TSC using MRI. In contrast, we primarily screened with ultrasonography and only performed an MRI on indication, either based on ultrasonography findings or based on clinical symptoms.…”

A study of Craniospinal Imaging in Patients with Anorectal Malformation

“…According to western literature craniospinal abnormalities especially spinal abnormalities are very common among patients with anorectal malformation; incidence is up to 46% [3][4][5][6][7]. In India it is up to 10% [8]. Some studies suggest that high resolution ultrasonography can detect craniospinal abnormalities efficiently but recently most of the studies suggest MRI as a routine investigation in patients with anorectal malformation because of high incidence of spinal abnormalities association with ARM [9].…”