MWY Leung, bpy Wong, TW Fan, NSY Chao, KW Chung, WK Kwok, KKW Liu

Abstract

Purpose: To review the association of occult spinal dysraphism in children with anorectal malformation. Methods: Fifty-eight children with anorectal malformation were reviewed. Twenty patients had high anomalies, whereas 6 had intermediate and 32 had low anomalies. Magnetic resonance imaging (MRI) of lumbosacral spine was performed on 10 children, because of abnormal preliminary ultrasonographic findings or persistent symptoms after surgery. Results: Four children had positive findings from the MRI. Tethered cord and intraspinal lipoma are the most common abnormalities. Lumbosacral spine X-ray was abnormal in only one patient. All patients had urodynamic assessment and abnormal cystometric finding was evident in two patients. Conclusions: Occult spinal dysraphism is common in children with anorectal malformation. A normal lumbosacral spine X-ray does not exclude the diagnosis. MRI of spine should be performed in suspicious cases. Urodynamic assessment is necessary to identify associated neurovesical dysfunction.