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Pediatric Surgery International
Published in: Pediatric Surgery International 8/2017

01-08-2017 | Original Article

Tethered cord in patients affected by anorectal malformations: a survey from the ARM-Net Consortium

Authors: María Fanjul, I. Samuk, P. Bagolan, E. Leva, C. Sloots, C. Giné, D. Aminoff, P. Midrio, On behalf of the ARM-Net Consortium

Published in: Pediatric Surgery International | Issue 8/2017

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Abstract

Purpose

The goal of this study was to determine the degree of consensus in the management of spinal cord tethering (TC) in patients with anorectal malformation (ARM) in a large cohort of European pediatric centers.

Methods

A survey was sent to pediatric surgeons (one per center) members of the ARM-Net Consortium.

Results

Twenty-four (86%) from ten different countries completed the survey. Overall prevalence of TC was: 21% unknown, 46% below 15, and 29% between 15 and 30%. Ninety-six agreed on screening all patients for TC regardless the type of ARM and 79% start screening at birth. Responses varied in TC definition and diagnostic tools. Fifty percent of respondents prefer ultrasound (US), 21% indicate either US or magnetic resonance (MRI) based on a pre-defined risk of presenting TC, and 21% perform both. Discrepancy exists in complementary test: 82% carry out urodynamic studies (UDS) and only 37% perform somatosensory-evoked potentials (SSEP). Prophylactic untethering is performed in only two centers (8%).

Conclusions

Survey results support TC screening in all patients with ARM and conservative management of TC. There is discrepancy in the definition of TC, screening tools, and complementary test. Protocols should be developed to avoid such variability in management.
Appendix
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Metadata
Title
Tethered cord in patients affected by anorectal malformations: a survey from the ARM-Net Consortium
Authors
María Fanjul
I. Samuk
P. Bagolan
E. Leva
C. Sloots
C. Giné
D. Aminoff
P. Midrio
On behalf of the ARM-Net Consortium
Publication date
01-08-2017
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Surgery International / Issue 8/2017
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-017-4105-4

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