Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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Dorsal midline cutaneous stigmata associated with occult spinal dysraphism in pediatric patients

  • Sung, Hyun Jung (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Lee, Hyun-Seung (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
  • 투고 : 2018.06.28
  • 심사 : 2018.10.01
  • 발행 : 2019.02.15
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초록

Purpose: To investigate the prevalence of occult spinal dysraphism (OSD) and subsequent neurosurgery in pediatric patients with isolated or combined dorsal midline cutaneous stigmata with or without other congenital malformations. Methods: We carried out a retrospective review of patients who underwent sonography or magnetic resonance imaging (MRI) for OSD because of suspicion of dorsal midline cutaneous stigmata (presumed to be a marker for OSD) between January 2012 and June 2017. Information about patient characteristics, physical examination findings, spinal ultrasound and MRI results, neurosurgical notes, and accompanying congenital anomalies was collected. Results: Totally 250 patients (249 ultrasound and one MRI screening) were enrolled for analysis. Eleven patients underwent secondary MRI examinations. The prevalence of OSD confirmed by an MRI was 2.4% (6 patients including one MRI screening). Five patients (2%) had tethered cord and underwent prophylactic neurosurgery, 3 of whom had a sacrococcygeal dimple and a fibrofatty mass. Prevalence of tethered cord increased as markers associated with a sacrococcygeal dimple increased (0.5% of the isolated marker group, 8.1% of the 2-marker group, and 50% of the 3-marker group). Incidence of OSD with surgical detethering in 17 other congenital anomaly patients was 11.8%, which was higher than the 1.3% in 233 patients without other congenital anomalies. Conclusion: Our results suggest that the presence of dorsal midline cutaneous stigmata, particularly fibrofatty masses, along with a sacrococcygeal dimple is associated with OSD or cord tethering requiring surgery. OSD should be suspected in patients with concurrent occurrence of other congenital anomalies.

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참고문헌

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피인용 문헌

  1. Do all newborns with an isolated sacrococcygeal dimple require investigation for spinal dysraphism? vol.104, pp.8, 2019, https://doi.org/10.1136/archdischild-2019-317058
  2. Risk of occult spinal dysraphism based on lumbosacral cutaneous manifestations vol.9, 2019, https://doi.org/10.1177/20503121211037172
  3. Spinale Sonografie bei Neugeborenen mit lumbosakralen Hautveränderungen vol.10, pp.4, 2021, https://doi.org/10.1055/a-1438-0526