Abstract
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.
Key words
imperforate anus - tethered cord - anorectal malformation
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M.D. Keiichi Uchida
Department of Gastrointestinal and Pediatric Surgery
Mie University Graduate School of Medicine
Edobashi 2-174
Tsu, Mie 514-8507
Japan
Email: keiichiuchida0815@yahoo.co.jp
