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Tethered cord associated with anorectal malformation

Kazuyoshi Morimoto1, Osamu Takemoto, Akatsuki Wakayama

  • 1Department of Neurosurgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan. fr8kmrmt@mch.pre.osaka.jp

Pediatric Neurosurgery
|February 5, 2003
PubMed

Insights

This study highlights the association between tethered spinal cords and anorectal malformations in children. Early spinal cord imaging is crucial for diagnosing these often-hidden conditions and guiding neurosurgical intervention.

Area of Science:

  • Pediatric Neurosurgery
  • Congenital Malformations
  • Spinal Cord Anomalies

Background:

  • Tethered cord syndrome can present with various congenital anomalies.
  • Anorectal malformations (ARMs) are sometimes associated with spinal cord abnormalities.
  • The link between ARMs and tethered cords, especially without skin stigma, requires further investigation.

Purpose of the Study:

  • To report on a cohort of children with co-occurring tethered cord and anorectal malformations.
  • To emphasize the importance of neurosurgical evaluation in children with ARMs.
  • To explore potential hypotheses for the observed association.

Main Methods:

  • Retrospective review of 10 pediatric patients with tethered cord and ARM.
  • Analysis of surgical data for spinal cord untethering.
  • Radiographic examination of the caudal spine for tethered cord diagnosis.

Main Results:

  • Ten children (6 boys, 4 girls; mean age 1.7 years) with tethered cord and ARM were identified.
  • The ARMs included vesicointestinal fissures, cloacal exstrophies, and rectovesical/rectobulbar fistulas.
  • Eight patients lacked typical lumbosacral skin stigmata, underscoring the need for imaging.

Conclusions:

  • A significant association exists between anorectal malformations and tethered spinal cords.
  • Neurosurgical correction of tethered cords may be beneficial for associated neurological deficits.
  • Spinal cord imaging is essential for accurate diagnosis in this patient population.

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