TY - JOUR
T1 - Magnetic Resonance Imaging of the Lumbosacral Spine in Children with Chronic Constipation or Non-Retentive Fecal Incontinence
T2 - A Prospective Study
AU - Bekkali, Noor L.Houda
AU - Hagebeuk, Eveline E.O.
AU - Bongers, Marloes E.J.
AU - van Rijn, Rick R.
AU - Van Wijk, Michiel P.
AU - Liem, Olivia
AU - Benninga, Marc A.
PY - 2010/3
Y1 - 2010/3
N2 - Objective: To determine the prevalence of lumbosacral spine (LSS) abnormalities in children with defecation disorders, intractable constipation, or non-retentive fecal incontinence (NRFI) and evaluate whether LSS abnormalities on magnetic resonance imaging (MRI) are clinically detected by neurologic examination. Study design: MRI of the LSS and complete neurologic examination by a pediatric neurologist blinded to the MRI results were performed in patients with intractable defecation disorders. Results: Patients with intractable constipation (n = 130; 76 males; median age, 11 years; range, 6-18 years), and patients with NRFI (n = 28; 18 males; median age, 10 years; range, 7-15 years) participated. One occult spina bifida (OSB) and 3 terminal filum lipomas were found in patients with a normal neurologic examination. One patient had a terminal filum lipoma and neurologic complaints. Gluteal cleft deviation was found in 3 of 4 patients with LSS abnormalities. Neurosurgical treatment was not required in any patient during the 12-week follow-up. Conclusions: MRI showed LSS abnormalities in 3% of patients with defecation disorders and normal neurologic examination, all of whom reported symptom relief at the 12-week follow-up without neurosurgical intervention. Thus, whether or not LSS abnormalities play a role in defecation disorders remains unclear.
AB - Objective: To determine the prevalence of lumbosacral spine (LSS) abnormalities in children with defecation disorders, intractable constipation, or non-retentive fecal incontinence (NRFI) and evaluate whether LSS abnormalities on magnetic resonance imaging (MRI) are clinically detected by neurologic examination. Study design: MRI of the LSS and complete neurologic examination by a pediatric neurologist blinded to the MRI results were performed in patients with intractable defecation disorders. Results: Patients with intractable constipation (n = 130; 76 males; median age, 11 years; range, 6-18 years), and patients with NRFI (n = 28; 18 males; median age, 10 years; range, 7-15 years) participated. One occult spina bifida (OSB) and 3 terminal filum lipomas were found in patients with a normal neurologic examination. One patient had a terminal filum lipoma and neurologic complaints. Gluteal cleft deviation was found in 3 of 4 patients with LSS abnormalities. Neurosurgical treatment was not required in any patient during the 12-week follow-up. Conclusions: MRI showed LSS abnormalities in 3% of patients with defecation disorders and normal neurologic examination, all of whom reported symptom relief at the 12-week follow-up without neurosurgical intervention. Thus, whether or not LSS abnormalities play a role in defecation disorders remains unclear.
UR - http://www.scopus.com/inward/record.url?scp=76749147754&partnerID=8YFLogxK
U2 - 10.1016/j.jpeds.2009.09.048
DO - 10.1016/j.jpeds.2009.09.048
M3 - Article
C2 - 19892365
AN - SCOPUS:76749147754
SN - 0022-3476
VL - 156
SP - 461-465.e1
JO - Journal of Pediatrics
JF - Journal of Pediatrics
IS - 3
ER -