Document Detail


Tethered cord in patients with anorectal malformation: preliminary results.
MedLine Citation:
PMID:  19680666     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A tethered cord (TC) has been reported in as much as 50% of the patients affected by anorectal malformation (ARM). No guidelines for timing and modality of diagnosis and treatment have been established. We present the preliminary results of a multidisciplinary protocol carried out at our center. METHODS: Seventy-four ARM patients underwent spinal magnetic resonance imaging (MRI). All TC patients underwent videourodynamic (UD), somatosensory-evoked potentials (SEPs), and neurological examination at baseline and, if normal, at 5 and 10 years of age. Conversely, when UD or SEP abnormalities were detected the follow-up was individually tailored at shorter time. RESULTS: 25/74 patients had a neuroradiological TC (33.7%). Based on the results of UD, SEP, and neurological status, four patients were untethered, eight are possible candidates, nine are stable, and four were excluded because of incomplete data. DISCUSSION: Tethered cord is frequent in ARM patients. Because neurological deficits secondary to TC can contribute to neurological disability, we recommend routine MRI examination and a multidisciplinary program of follow-up in cases of TC. Preliminary results suggest the combined use of SEPs and UD could represent a useful adjunct to clinical examination in patients in whom a "wait and see" approach is preferred to the prophylactic surgery.
Authors:
A Suppiej; L Dal Zotto; A Cappellari; A Traverso; M Castagnetti; P Drigo; P Midrio
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric surgery international     Volume:  25     ISSN:  1437-9813     ISO Abbreviation:  Pediatr. Surg. Int.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-25     Completed Date:  2009-12-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8609169     Medline TA:  Pediatr Surg Int     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  851-5     Citation Subset:  IM    
Affiliation:
Child Neurology and Clinical Neurophysiology Unit, University of Padua, Padua, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Anal Canal / abnormalities*
Child
Child, Preschool
Diagnostic Techniques, Urological
Digestive System Abnormalities / complications,  diagnosis*
Evoked Potentials, Somatosensory
Female
Humans
Magnetic Resonance Imaging
Male
Neural Tube Defects / complications,  diagnosis*
Neurologic Examination
Rectum / abnormalities*
Tibial Nerve
Urodynamics

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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