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Pediatric Surgery International
Published in: Pediatric Surgery International 9/2017

01-09-2017 | Original Article

Long-term functional outcome after untethering surgery for a tethered spinal cord in patients with anorectal malformations

Authors: Mikihiro Inoue, Keiichi Uchida, Kohei Otake, Yuka Nagano, Tadanobu Shimura, Kiyoshi Hashimoto, Kohei Matsushita, Yuhki Koike, Toshio Matsubara, Masato Kusunoki

Published in: Pediatric Surgery International | Issue 9/2017

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Abstract

Background

Anorectal malformation (ARM) is associated with a tethered spinal cord (TSC). Long-term functional outcome of untethering surgery for TSC in patients with ARM has not been well evaluated.

Methods

Patients aged 7 years and older who underwent repair of ARM and spinal magnetic resonance imaging from January 1995 to December 2008 were reviewed retrospectively. Untethering surgery was performed in all patients who were diagnosed with TSC, regardless of the presence or of neurological symptoms. Clinical symptoms reflecting anorectal, urinary, and lower limb function were compared between patients complicated with TSC (TSC group, n = 17) and those without TSC (non-TSC group, n = 14).

Results

The median age at functional evaluation was 11.7 and 12.9 years in the TSC and non-TSC groups, respectively (p = 0.52). Untethering surgery for TSC was performed at a median age of 1.3 years. Preoperative urinary and lower limb dysfunction, except for vesicoureteral reflux in the TSC group in one patient, was improved after surgical detethering. Current anorectal function was comparable between the groups.

Conclusions

Long-term functional outcome in patients with ARM and TSC undergoing untethering surgery is equivalent to that in those without TSC. Prophylactic surgical detethering for patients with ARM and TSC can be a treatment of choice to maximize neurological functional outcome.
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Metadata
Title
Long-term functional outcome after untethering surgery for a tethered spinal cord in patients with anorectal malformations
Authors
Mikihiro Inoue
Keiichi Uchida
Kohei Otake
Yuka Nagano
Tadanobu Shimura
Kiyoshi Hashimoto
Kohei Matsushita
Yuhki Koike
Toshio Matsubara
Masato Kusunoki
Publication date
01-09-2017
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Surgery International / Issue 9/2017
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-017-4127-y

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