Li Wei,Wang Fei,Lin Gang,et al.Clinical and radiological characteristics of congenital spinal deformity associated with anorectal malformation-[J].Journal of Clinical Pediatric Surgery,,21():1012-1018.[doi:10.3760/cma.j.cn101785-202209024-003]
Clinical and radiological characteristics of congenital spinal deformity associated with anorectal malformation-
- Keywords:
- Anorectal Malformations; Spinal Deformity; Clinical Classification; Radiographic Characteristies
- Abstract:
- Objective To explore the clinical subtypes and radiological characteristics for children with anorectal malformation (ARM) associated with congenital spine deformity.Methods A retrospective review was conducted for 72 ARM children patients who had received treatment between January 2008 and December 2019.There were 38 boys and 34 girls.Based upon the range of vertebral anomalies, they were assigned into Group Ⅰ (n=30, 41.7%):ARM associated with simple thoracic/lumbar vertebral anomalies;Group Ⅱ(n=35, 48.6%):those with simple sacral agenesis and Group Ⅲ (n=7, 9.7%):those with both sacral agenesis and thoracic/lumbar vertebral anomalies.Demographic profiles, ARM type, type/location of vertebral anomalies, sacral agenesis, rib anomalies and concomitant defects of other systems were recorded.SPSS 18.0 was used for statistical analysis.Since all measurement data in this study did not obey normal distribution, M(Q1, Q3) was used to describe the measurement data. Numerical comparison among three groups was conducted by Kruskal-Wallis rank sum test for comparison of multiple groups, and Nemenyi test was used for pound-wise comparison.Fisher’s exact probability method was used to compare the sex ratio, types of anorectal malformations, combined with other systemic malformations, distribution of vertebral malformations, rib malformations, and sacral malformations among the three groups.P<0.05 showed statistical significance.Results The average evaluation age of Group Ⅱ was 4.00(3.00, 5.00) months and it was greater than Group Ⅰ/Ⅲ (P=0.009).No differences existed in gender or ARM type among three groups.Spinal deformity predominated in main thoracic region (24/30) and proximal thoracic region (17/30) in Group Ⅰ whereas lumbar region (6/7) and thoracolumbar region (4/7) were affected in Group Ⅲ (P=0.002).No significant differences in type/level of vertebral anomaly or percentage of multiple anomalies existed between Groups Ⅰ and Ⅲ.Severe sacral agenesis was more common in Group Ⅱ than Group Ⅲ (P=0.020).The prevalence of associated rib anomalies was higher in Group Ⅰ than Group Ⅱ/Ⅲ (P=0.002).And Group Ⅰ had higher incidence of cardiac defects (P=0.031) and a lower incidence of intraspinal anomalies (P=0.001) than Group Ⅱ/Ⅲ.Conclusion ARM patients associated with spine deformity may be divided into three clinical subtypes.Clinical and radiological characteristics vary among three subtypes and carry important implications for disease evaluations and treatments.
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Memo
收稿日期:2022-09-15。
基金项目:南京市卫生科技发展专项资金项目（YKK20123）
通讯作者:汪飞,Email:wf051231034@163.com