Tethered cord in patients affected by anorectal malformations: a survey from the ARM-Net Consortium

ARM-Net Consortium

Research output: Contribution to journalArticle

Abstract

PURPOSE: The goal of this study was to determine the degree of consensus in the management of spinal cord tethering (TC) in patients with anorectal malformation (ARM) in a large cohort of European pediatric centers.

METHODS: A survey was sent to pediatric surgeons (one per center) members of the ARM-Net Consortium.

RESULTS: Twenty-four (86%) from ten different countries completed the survey. Overall prevalence of TC was: 21% unknown, 46% below 15, and 29% between 15 and 30%. Ninety-six agreed on screening all patients for TC regardless the type of ARM and 79% start screening at birth. Responses varied in TC definition and diagnostic tools. Fifty percent of respondents prefer ultrasound (US), 21% indicate either US or magnetic resonance (MRI) based on a pre-defined risk of presenting TC, and 21% perform both. Discrepancy exists in complementary test: 82% carry out urodynamic studies (UDS) and only 37% perform somatosensory-evoked potentials (SSEP). Prophylactic untethering is performed in only two centers (8%).

CONCLUSIONS: Survey results support TC screening in all patients with ARM and conservative management of TC. There is discrepancy in the definition of TC, screening tools, and complementary test. Protocols should be developed to avoid such variability in management.

Original languageEnglish
Pages (from-to)849-854
Number of pages6
JournalPediatric Surgery International
Volume33
Issue number8
DOIs
Publication statusPublished - Aug 2017

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Pediatrics
Somatosensory Evoked Potentials
Urodynamics
Spinal Cord
Magnetic Resonance Spectroscopy
Parturition
Surveys and Questionnaires
Anorectal Malformations
Conservative Treatment
Surgeons

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Tethered cord in patients affected by anorectal malformations : a survey from the ARM-Net Consortium. / ARM-Net Consortium.

In: Pediatric Surgery International, Vol. 33, No. 8, 08.2017, p. 849-854.

Research output: Contribution to journalArticle

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title = "Tethered cord in patients affected by anorectal malformations: a survey from the ARM-Net Consortium",
abstract = "PURPOSE: The goal of this study was to determine the degree of consensus in the management of spinal cord tethering (TC) in patients with anorectal malformation (ARM) in a large cohort of European pediatric centers.METHODS: A survey was sent to pediatric surgeons (one per center) members of the ARM-Net Consortium.RESULTS: Twenty-four (86{\%}) from ten different countries completed the survey. Overall prevalence of TC was: 21{\%} unknown, 46{\%} below 15, and 29{\%} between 15 and 30{\%}. Ninety-six agreed on screening all patients for TC regardless the type of ARM and 79{\%} start screening at birth. Responses varied in TC definition and diagnostic tools. Fifty percent of respondents prefer ultrasound (US), 21{\%} indicate either US or magnetic resonance (MRI) based on a pre-defined risk of presenting TC, and 21{\%} perform both. Discrepancy exists in complementary test: 82{\%} carry out urodynamic studies (UDS) and only 37{\%} perform somatosensory-evoked potentials (SSEP). Prophylactic untethering is performed in only two centers (8{\%}).CONCLUSIONS: Survey results support TC screening in all patients with ARM and conservative management of TC. There is discrepancy in the definition of TC, screening tools, and complementary test. Protocols should be developed to avoid such variability in management.",
author = "{ARM-Net Consortium} and Mar{\'i}a Fanjul and I Samuk and P Bagolan and E Leva and C Sloots and C Gin{\'e} and D Aminoff and P Midrio",
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AU - ARM-Net Consortium

AU - Fanjul, María

AU - Samuk, I

AU - Bagolan, P

AU - Leva, E

AU - Sloots, C

AU - Giné, C

AU - Aminoff, D

AU - Midrio, P

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N2 - PURPOSE: The goal of this study was to determine the degree of consensus in the management of spinal cord tethering (TC) in patients with anorectal malformation (ARM) in a large cohort of European pediatric centers.METHODS: A survey was sent to pediatric surgeons (one per center) members of the ARM-Net Consortium.RESULTS: Twenty-four (86%) from ten different countries completed the survey. Overall prevalence of TC was: 21% unknown, 46% below 15, and 29% between 15 and 30%. Ninety-six agreed on screening all patients for TC regardless the type of ARM and 79% start screening at birth. Responses varied in TC definition and diagnostic tools. Fifty percent of respondents prefer ultrasound (US), 21% indicate either US or magnetic resonance (MRI) based on a pre-defined risk of presenting TC, and 21% perform both. Discrepancy exists in complementary test: 82% carry out urodynamic studies (UDS) and only 37% perform somatosensory-evoked potentials (SSEP). Prophylactic untethering is performed in only two centers (8%).CONCLUSIONS: Survey results support TC screening in all patients with ARM and conservative management of TC. There is discrepancy in the definition of TC, screening tools, and complementary test. Protocols should be developed to avoid such variability in management.

AB - PURPOSE: The goal of this study was to determine the degree of consensus in the management of spinal cord tethering (TC) in patients with anorectal malformation (ARM) in a large cohort of European pediatric centers.METHODS: A survey was sent to pediatric surgeons (one per center) members of the ARM-Net Consortium.RESULTS: Twenty-four (86%) from ten different countries completed the survey. Overall prevalence of TC was: 21% unknown, 46% below 15, and 29% between 15 and 30%. Ninety-six agreed on screening all patients for TC regardless the type of ARM and 79% start screening at birth. Responses varied in TC definition and diagnostic tools. Fifty percent of respondents prefer ultrasound (US), 21% indicate either US or magnetic resonance (MRI) based on a pre-defined risk of presenting TC, and 21% perform both. Discrepancy exists in complementary test: 82% carry out urodynamic studies (UDS) and only 37% perform somatosensory-evoked potentials (SSEP). Prophylactic untethering is performed in only two centers (8%).CONCLUSIONS: Survey results support TC screening in all patients with ARM and conservative management of TC. There is discrepancy in the definition of TC, screening tools, and complementary test. Protocols should be developed to avoid such variability in management.

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