Predictive value of spinal bone anomalies for spinal cord abnormalities in patients with anorectal malformations

Esposito, Giacomo; Totonelli, Giorgia; Morini, Francesco; Contini, Giorgia; Mosiello, Giovanni; Longo, Daniela; Schingo, Paolo; Marras, Carlo Efisio; Bagolan, Pietro; Iacobelli, Barbara Daniela

doi:10.1016/j.jpedsurg.2021.05.011

Cited by 7 publications

(13 citation statements)

References 33 publications

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“…In the literature, the prevalence of SCA in ARM patients ranged from 26 up to 60%, which is higher than in our study [ 13 , 14 , 18 ]. In contrast to our study, some other studies included vertebral anomalies as SCA or solely used MRI as screening method, which potentially led to a higher prevalence in these studies compared to ours [ 17 , 18 ]. Still, prevalence in studies without a standard screening protocol may be low due to underdiagnoses and missing data, and the lack of documentation on whether additional imaging studies were performed.…”

Section: Discussioncontrasting

confidence: 79%

“…Therefore, screening for SCA in all ARM patients is recommended [ 9 ]. In current practice, discussion remains on the optimal imaging study for identification of SCA [ 13 , 18 , 19 ]. Although magnetic resonance imaging (MRI) of the spinal cord is accepted as golden standard for identification, an ultrasound (US) of the spinal cord might also be a reliable and a quicker alternative imaging modality with lower costs [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

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Spinal cord anomalies in children with anorectal malformations: a retrospective cohort study

et al. 2023

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Purpose First, to assess the number of spinal cord anomalies (SCA), specifically tethered spinal cord (TSC) in patients with anorectal malformations (ARM), identified with spinal cord imaging (i.e. spinal cord US and/or MRI). Second, to report outcomes after TSC treatment. Methods A retrospective mono-center study was performed. All ARM patients born between January 2000 and December 2021 were included. Screening for SCA consisted of spinal cord US and/or MRI. Radiology reports were scored on presence of SCA. Data were presented with descriptive statistics. Results In total, 254 patients were eligible for inclusion, of whom 234 (92.1%) underwent spinal cord imaging. In total, 52 (22.2%) patients had a SCA, diagnosed with US (n = 20, 38.5%), MRI (n = 10, 19.2%), or both US and MRI (n = 22, 42.3%), of whom 12 (23.5%) with simple, 27 (52.7%) intermediate, and 12 (23.5%) complex ARM types. TSC was identified in 19 patients (8.1%), of whom 4 (21.1%) underwent uncomplicated neurosurgical intervention. Conclusions SCA were present in 22% of ARM patients both in simple, as well as more complex ARM types. TSC was present in 19 patients with SCA, of whom 4 underwent uncomplicated neurosurgical intervention. Therefore, screening for SCA seems to be important for all ARM patients, regardless of ARM type. Level of Evidence Level III.

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Section: Discussioncontrasting

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Spinal cord anomalies in children with anorectal malformations: a retrospective cohort study

et al. 2023

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“…In our study, we found that 57.9% of the screened patients with ARMs had coexistent spinal dysraphism. This prevalence ranged 16.2% in Ruangtrakool et al [14], 22% in Oh et al [15] and 42% in Esposito et al [17] studies.…”

Section: Discussionmentioning

confidence: 84%

Role of ultrasonography in screening of spinal dysraphism in infants at risk

Hussein

Ahmed

Osman

et al. 2022

Egypt J Radiol Nucl Med

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Background Spinal dysraphism (SD) encompasses congenital spinal defects that result from inappropriate fusion of the different midline osseous, mesenchymal, and neural elements. The primary tools for diagnosis of SD are both spinal ultrasonography (USG) and magnetic resonance imaging (MRI). Spinal USG is growingly being used as an initial screening modality with sensitivities and accuracies equivalent to those of MRI. Anorectal malformations (ARM) have ultimate association with many other congenital abnormalities, of which spinal dysraphism is one of the most common. The main aim of study was to assess the diagnostic accuracy of spinal USG as a screening modality in comparison with MRI in infants with closed spinal dysraphism. We also endeavored to highlight the associated spinal dysraphism radiological findings in patients with either ARM or back cutaneous stigmata. Results Our prospective diagnostic comparative study included 33 patients, all of whom underwent both MRI and USG. Both MRI and USG showed appreciable agreement in the assessment of spinal dysraphism. In comparison with the gold standard MRI, spinal USG revealed comparable diagnostic metrics: specificity (98.6–100%), sensitivity (66.6–91.6%), PPV (90–100%) and NPV (94.1–98.7%) in diagnosis of different types of spinal dysraphism. The main clinical presentation of nineteen patients was anorectal malformation (ARM), 11 of whom (57.9%) had evidence of associated spinal dysraphism. The most common types of ARM were cloacal malformation, recto-urethral fistula, and rectal atresia with no fistula. On the other hand, sixteen patients were mainly presented with back cutaneous stigmata, 11 of whom (68.8%) had associated spinal dysraphism. The most common presenting cutaneous stigmata were low back swelling and atypical dimples. Conclusion The front-line screening modality for infants with closed SD should be spinal USG, however, its main limitation is the restrained time window in the first 6 months of life. Infants with ARM should be screened for spinal anomalies, especially those with high and complex types. Infants with high-risk back cutaneous stigmata should be similarly screened, as well.

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“…Congenital malformations of the spine and spinal cord include numerous entities that vary in complexity, 1 and may directly affect the patients' quality of life 2 . Although some anomalies, such as isolated hemivertebrae, may not be associated with severe symptoms, 3 others may be associated with poor prognosis 4 .…”

Section: Introductionmentioning

confidence: 99%

“…Congenital malformations of the spine and spinal cord include numerous entities that vary in complexity, 1 and may directly affect the patients' quality of life. 2 Although some anomalies, such as isolated hemivertebrae, may not be associated with severe symptoms, 3 others may be associated with poor prognosis. 4 Newborns with congenital malformations of the spine and spinal cord are usually treated after birth, and the treatment typically depends on the severity of the deformity and the presence of other related anomalies.…”

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confidence: 99%

A comparison of the accuracy of fetal magnetic resonance imaging and ultrasonography for the diagnosis of fetal congenital malformations of the spine and spinal cord

et al. 2022

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Purpose To determine the diagnostic value of fetal magnetic resonance imaging (MRI) for congenital spine/spinal cord malformations. Methods This single‐center retrospective study included 120 cases of fetal spine/spinal cord abnormalities detected using fetal ultrasonography (US) and further examined by fetal MRI between 2016 and 2020. Cases were divided into three groups (congenital spine, spinal cord, and spine + spinal cord malformations) based on US assessment. We analyzed the accuracy of fetal US and MRI relative to postnatal imaging. Results The diagnostic accuracy of fetal MRI for fetal spinal cord, spine, and spine + spinal cord malformations was 86.2% (25/29), 89.4% (42/47), and 86.3% (38/44), respectively, and the corresponding rates for fetal US were 51.7% (15/29), 87.2% (41/47), and 68.2% (30/44). The diagnostic accuracy did not differ between fetal MRI and US for congenital spine malformations (p > 0.05); for congenital spinal cord malformations and congenital spine + spinal cord malformations, the diagnostic accuracy was significantly higher for fetal MRI than for fetal US (p < 0.05). Conclusions Fetal MRI is effective in the assessment of congenital spine/spinal cord malformations. It can yield information that supplements US findings, especially for congenital spinal cord malformations, and can improve the accuracy of fetal diagnosis.

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Predictive value of spinal bone anomalies for spinal cord abnormalities in patients with anorectal malformations

Cited by 7 publications

References 33 publications

Spinal cord anomalies in children with anorectal malformations: a retrospective cohort study

Spinal cord anomalies in children with anorectal malformations: a retrospective cohort study

Role of ultrasonography in screening of spinal dysraphism in infants at risk

A comparison of the accuracy of fetal magnetic resonance imaging and ultrasonography for the diagnosis of fetal congenital malformations of the spine and spinal cord

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