Tethered cord and associated vertebral anomalies in children and infants with imperforate anus: evaluation with MR imaging and plain radiography.
OBJECTIVE
To evaluate in children and infants with imperforate anus the prevalence and types of occult myelodysplasia that may result in tethered cord and the association of these lesions with vertebral anomalies.


METHODS
Records and images were retrospectively reviewed in 86 patients who underwent spine magnetic resonance imaging and had either low-level imperforate anus (n = 30), intermediate-level imperforate anus (n = 15), or high-level imperforate anus (n = 41).


RESULTS
Thirty-one of 86 patients (36%) had occult myelodysplasia suggestive of tethered cord (27% of all patients with low-, 33% of all patients with intermediate-, and 44% of all patients with high-level lesions). Of these 31 patients, 16(52%) were asymptomatic, 24, (77%) had a thickened fatty filum, 13 (42%) had normal conus position, and 23 (74%) had vertebral anomalies. Twenty-four of the 31 patients (77%) underwent surgical untethering.


CONCLUSIONS
A substantial number of patients with all types of imperforate anus have occult myelodysplasia that may necessitate surgical intervention, including those patients with normal spine radiographs.
Long
F R
FR
Department of Radiology, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, USA.
Hunter
J V
JV
Mahboubi
S
S
Kalmus
A
A
Templeton
J M
JM
D000015:Abnormalities, Multiple / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D000293:Adolescent; D001006:Anus, Imperforate / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D015995:Prevalence; D011859:Radiography; D012189:Retrospective Studies; D012447:Sacrum / Q000002:abnormalities / Q000000981:diagnostic imaging; D016136:Spina Bifida Occulta / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D013131:Spine / Q000002:abnormalities* / Q000000981:diagnostic imaging