Zhang Taotao,Zhao Qingshuang,Ying Jianbin,et al.Occurrences and treatments of tethered cord in children with anorectal malformations[J].Journal of Clinical Pediatric Surgery,,():56-60.[doi:10.3760/cma.j.cn101785-202208030-011]
Occurrences and treatments of tethered cord in children with anorectal malformations
- Abstract:
- Objective To explore the occurrence of anorectal malformation (ARM) plus tethered cord syndrome (TCS) and examine the significance of related treatments.Methods Medical records and imaging data were retrospectively reviewed for 105 children hospitalized with ARM from February 2018 to February 2022.According to the Wingspread classification,they were assigned into middle/high and low positions.Based upon the Krickenbeck classification,they were divided into with fistula and non-fistula.According to the findings of magnetic resonance imaging (MRI),they were divided into two groups of TCS and non-TCS.Correlation of TCS with age,ARM-related classification and other malformations were analyzed.Results There were TCS (n=29,27.6%) and non-TCS (n=76,72.4%).Among 55 cases (52.4%) of other malformations,37 cases had another malformation and 18 cases two or more other malformations.Wingspread classification and concurrent malformations were independent factors for TCS in ARM children.The probability of middle/high position plus TCS was 3.223 folds (OR=3.223,95%CI:1.128-9.210,P=0.029) higher than that in low position.Children with two or more other malformations were 10.120 folds (OR=10.120,95%CI:2.715-37.729,P=0.001) more prone to develop TCS than those with one other malformation.No significant difference existed in incision infection rate,length of hospitalization,effective rate,mortality rate or defecation functions between ARM children without TCS and those with TCS (P>0.05).After treatment,there was no significant inter-group difference in the improvement of defecation function (P>0.05).Conclusions The incidence of TCS is higher in middle/high ARM children and those with multiple system malformations.Lumbosacral MRI is recommended for detect the type and severity of TCS as early as possible in ARM children.It helps clinicians to optimize treatments for ARM children.If combined with TCS,tethered cord release is recommended for preventing further severe consequences of spinal cord injury.
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Memo
收稿日期:2022-8-17。
基金项目:福建省省级临床重点专科建设项目—福建省儿童医院小儿神经外科[闽卫医政(2023)1163号]
通讯作者:荆俊杰,Email:jjj0709@sina.com