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Embryological and clinical implications of the association between anorectal malformations and spinal dysraphisms.
- Source :
-
Pediatric surgery international [Pediatr Surg Int] 2017 Aug; Vol. 33 (8), pp. 843-847. Date of Electronic Publication: 2017 Jun 10. - Publication Year :
- 2017
-
Abstract
- Purpose: To describe the association of anorectal malformation (ARM) and spinal dysraphism (SD) in terms of impact on the management of SD and embryogenetic implications.<br />Methods: Patients with SD associated with (A) or without (B) ARM were included. The two groups were further divided into operated on (A1/B1) or not (A2/B2) for SD. Groups A and B were compared for type of SD (embryogenetic classification) and prevalence of neurosurgery; Groups A1 vs. A2 for type of ARM (Wingspread classification); Groups A1 vs. B1 for age at neurosurgery, neurophysiology, and clinical symptoms.<br />Main Results: One hundred twenty-one patients with SD, 83 with and 38 without ARM were consecutively treated (1999-2015). Group A was associated only with SDs developing after primary neurulation, corresponding to the period of cloacal septation and organogenesis (p = 0.0007). Untethering surgery was significantly less frequent in Group A (p < 0.0001 and p = 0.04, respectively). Higher ARMs were not associated with increased risk for neurosurgery. No other significant differences were detected.<br />Conclusions: In our series, ARMs were associated only with SD developing after primary neurulation, suggesting a single insult leading to both SD and the associated ARM. Neurosurgery is indicated less frequently in patients with ARM-associated SD, despite the similar preoperative clinical features.
- Subjects :
- Anorectal Malformations diagnostic imaging
Child
Embryonic Development
Female
Humans
Magnetic Resonance Imaging methods
Male
Neurosurgical Procedures methods
Retrospective Studies
Spinal Dysraphism diagnostic imaging
Anorectal Malformations complications
Anorectal Malformations embryology
Spinal Dysraphism complications
Spinal Dysraphism embryology
Subjects
Details
- Language :
- English
- ISSN :
- 1437-9813
- Volume :
- 33
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Pediatric surgery international
- Publication Type :
- Academic Journal
- Accession number :
- 28601900
- Full Text :
- https://doi.org/10.1007/s00383-017-4104-5