Journal of Pediatric Surgery
Volume 37, Issue 7 , Pages 966-969 , July 2002

Routine MRI evaluation of low imperforate anus reveals unexpected high incidence of tethered spinal cord

Presented at the 53rd Annual Meeting of the Section on Surgery of the American Academy of Pediatrics, San Francisco, California, October 19-21, 2001.

References 

  1. Levitt MA, Patel M, Rodriguez G, et al.  The tethered spinal cord in patients with anorectal malformations. J Pediatr Surg. 1997;32:462–468
  2. Long FR, Hunter JV, Mahboubi S, et al.  Tethered cord and associated anomalies in children and infants with imperforate anus: Evaluation with MR Imaging and plain radiography. Radiology. 1996;200:377–382
  3. Shaul DB, Harrison EA. Classification of Anorectal Malformations—Initial approach, diagnostic tests, and colostomy. Semin Pediatr Surg. 1997;6:187–195
  4. Koyanagi I, Iwasaki Y, Hida K, et al.  Surgical treatment supposed natural history of the tethered cord with occult spinal dysraphism. Child Nerv Syst. 1997;13:268–274
  5. McLone DG, La Marca F. The tethered spinal cord: Diagnosis, significance, and management. Semin Pediatr Neurol. 1997;4:192–208
  6. Hoffman HJ, Hendrick EB, Humphreys RP. The tethered spinal cord: Its protean manifestations, diagnosis, and surgical correction. Child's Brain. 1976;2:145–155
  7. McLone DG, Naidich TP. The tethered spinal cord. In:  McLaurin RL,  Schute L,  Venes JL, et al. editor. Pediatric Neurosurgery: Surgery of the Developing Nervous System. Philadelphia, PA: Saunders; 1989;p. 71–96
  8. Karrer FM, Flannery AM, Nelson MD, et al.  Anorectal malformations: Evaluation of associated spinal dysraphic syndromes. J Pediatr Surg. 1988;23:45–48
  9. Liptak GS. Tethered spinal cord: Update of an analysis of published articles. Eur J Pediatr Surg. 1995;1:21–23
  10. Pang D, Wilberger JE. Tethered cord syndrome in adults. J Neurosurg. 1982;57:32–47
  11. Kaney PM, Lemire RJ, Loeser JD, et al.  Management and long-term follow-up review of children with lipomyelomeningocele, 1952-1987. J Neurosurg. 1990;73:48–52
  12. Davidoff AM, Thompson CV, Grimm JK, et al.  Occult spinal dysraphism in patients with anal agenesis. J Pediatr Surg. 1991;26:1001–1005
  13. Warf BC, Scott RM. Anorectal and urogenital anomalies associated with spinal cord tethering. In:  Albright AL,  Pollack IF,  Adelson PD editor. Principles and Practices of Pediatric Neurosurgery. New York, NY: Thieme; 1999;p. 353–362
  14. Barson AJ. The vertebral level of the termination of the spinal cord during normal and abnormal development. J Anat. 1970;106:489–497
  15. Dias MS, Li V. Pediatric neurosurgical disease. Pediatr Clin North Am. 1998;45:1539–1578
  16. Rivosecchi M, Lucchetti MC, Zaccara A, et al.  Spinal dysraphism detected by magnetic resonance imaging in patients with anorectal anomalies: Incidence and clinical significance. J Pediatr Surg. 1995;30:488–490
  17. Tunnell WP, Austin JC, Barnes PD, et al.  Neuroradiological evaluation of sacral abnormalities in imperforate anus complex. J Pediatr Surg. 1987;22:58–61
  18. Sharif S, Allcutt D, Marks C, et al.  “Tethered cord syndrome”—Recent clinical experience. Br J Neurosurg. 1997;11:49–51
  19. Van Leeuwen R, Notermans NC, Vandertop WP. Surgery in adults with tethered cord syndrome: Outcome study with independent clinical review. J Neurosurg. 2001;94:205–209
  20. Yamada S, Lonser RR. Adult tethered cord syndrome. J Spinal Disorder. 2000;13:319–323
  21. Kaplan WE, McLone DG, Richards I. The neurological manifestations of the tethered spinal cord. J Urol. 1988;140:1285–1288
  22. Yoneyama T, Fukui J, Ohsutka K, et al.  Urinary tract dysfunctions in tethered spinal cord syndrome: Improvement after surgical untethering. J Urol. 1985;133:999–1001
  23. Cornette L, Verpoorten C, Lagae L, et al.  Tethered cord syndrome in occult spinal dysraphism: Timing and outcome of surgical release. Neurology. 1998;50:1761–1765
  24. Archibeck MJ, Smith JT, Carroll KL, et al.  Surgical release of tethered spinal cord: Survivorship analysis and orthopedic outcome. J Pediatr Orthopaed. 1997;17:773–776
  25. Heij HA, Nievelstein RAJ, de Zwart I, et al.  Abnormal anatomy of the lumbosacral region imaged by magnetic resonance in children with anorectal malformations. Arch Dis Child. 1996;74:441–444
  26. Appignani BA, Jaramillo D, Barnes PD, et al.  Dysraphic myelodysplasias associated with urogenital and anorectal anomalies: prevalence and types seen with MR imaging. Am J Radiol. 1994;163:1199–1203

☆ Address reprint requests to Kurt D. Newman, MD, Professor of Surgery and Pediatrics, George Washington University, Department of Pediatric Surgery, Children's National Medical Center, 111 Michigan Ave NW, Washington DC 20010.

PII: S0022-3468(02)00004-0

doi: 10.1053/jpsu.2002.33817

Journal of Pediatric Surgery
Volume 37, Issue 7 , Pages 966-969 , July 2002

Article Tools