Perferated anus tethered cord











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Personalised recommendations. Pre- and postoperative urodynamic and anorectal manometric findings in children operated upon for a primary tethered cord. The association of anorectal malformation and spinal dysraphism is demonstrated by the split notochord model in fetal rats. Occult spinal dysraphism is associated with anorectal malformation. Spine evaluation in children with anorectal malformations. Pediatr Neurosurg

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Tethered Spinal Cord And Vacterl Association

A tethered spinal cord is a condition where there is restricted movement of the spinal cord, which lies within the spine, surrounded by the vertebrae. With this particular surgery, the risks include excessive bleeding, infection, injury to the spinal cord, persistent leaking of spinal fluid and anesthesia complications. One of the 4 patients had previous USG spine performed in neonatal period, showing low lying conus which correlated with the MRI findings. It is associated with thickened filum, intraspinal lipoma and syringomyelia. However the sensitivity of USG of spine to detect OSD decreases beyond neonatal period because of ossification of sacral bone. Some authors suggest that prophylactic untethering of cord should be considered to prevent bowel and urinary symptoms in future. In our centre, the bowel function of patients was assessed at the age of three years.

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Utility of spinal mri in children with anorectal malformation

If untreated, tethering of the spinal cord can cause permanent damage. Occult spinal dysraphism in patients with anal agenesis. To define the incidence in children with low lesions, the authors reviewed their experience with a protocol employing routine magnetic resonance imaging MRI , regardless of the level of the lesion, to determine the presence of a tethered cord in all children with imperforate anus. Untethering of spinal cord was performed in two patients. Plain X-ray of lumbosacral spine was performed in all 4 patients with only one patient showing abnormal finding of absent segmentation of sacrum.

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Description: A tethered spinal cord can be caused during fetal development, or it can be from scar tissue in children who have had spine surgery. A syndrome of multiple congenital anomalies associated with teratogenic exposure. However the sensitivity of USG of spine to detect OSD decreases beyond neonatal period because of ossification of sacral bone. We performed USG of spine in 6 patients in the neonatal period with one positive finding of low lying cord. We believe that MRI of lumbosacral spine should be performed if the USG spine is abnormal, or if the patients have persistent bowel incontinence, urological or orthopaedic symptoms after anorectoplasty. Trouble with, or changes in, bowel and bladder function Loss of strength in the legs or feet Pain in the legs or back An abnormal walking pattern, such as walking on the toes A difference in the size of the right and left legs or feet New or increased spasticity Unusual birthmarks or dimples on the back may indicate an underlying tethered spinal cord Ideally the tethered cord is treated soon after diagnosis because long-standing symptoms may not improve after the spinal cord is untethered. One patient had no segmentation of sacrum and subsequently found to have OSD. A normal lumbosacral spine X-ray does not exclude the diagnosis. Figure 1 Detrusor overactivity, detrusor-sphincter dyssynergia and high voiding pressure in a child with occult spinal dysraphism.
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