Tethered spinal cord in patients with anorectal malformations

Abstract

Anorectal malformations (ARM) are commonly associated with maldevelopment of neighbouring structures derived from the caudal cell mass. Bony spinal anomalies and malformations of the spinal cord are among the more frequent findings. The association of ARM and tethered cord has been repeatedly documented. The reported prevalence of spinal cord abnormalities in patients with ARM varies between around 10% (4/44, 15/106, 22/223), and 50% and more (40/76, 25/50, 54/89). A prevalence of between 20 and 35% appears most plausible (27/111, 22/63). The majority of tethered cord lesions will be missed unless routine screening with ultrasound and magnetic resonance imaging (MRI) is applied, as was shown by Tuuha et al. in a retrospective 10-year analysis. With systematic screening, the percentage of spinal cord abnormalities found jumped from 4% to 20%. In surgical series of tethered cord, associated ARM are comparatively rare (7/435, 35/480 own experience). © 2006 Springer-Verlag.