Assessment of sphincter muscle function before and after posterior sagittal anorectoplasty using a magnetic spinal stimulation technique

J Pediatr Surg. 2002 Apr;37(4):617-22. doi: 10.1053/jpsu.2002.31621.

Abstract

Purpose: The authors used a magnetic spinal stimulation technique to assess both the preoperative sphincter function and the effect of operative intervention on the sphincter muscle in patients with anorectal malformations.

Methods: The authors examined 5 patients with an anorectal malformation consisting of 4 high-type cases and 1 intermediate-type case, that all had undergone posterior sagittal anorectoplasty during the previous 2-year period. Control data also were obtained from 11 age-matched healthy children. A contraction of the external anal sphincter (EAS) was evoked by magnetic stimulation of the sacral roots with a figure-of-eight coil at the level of the lumber and sacral segments. EAS electromyograms then were recorded at the anal verge.

Results: The preoperative motor latencies at L4 stimulation increased significantly more in the patients than in the controls (5.9 +/- 0.5 msec v 4.1 +/- 0.7 msec during left side recording). In the postoperative examination (1 to 5 months after operation), the mean maximum amplitude decreased slightly without any significant difference, where as the latency was almost identical to the preoperative data.

Conclusion: These results suggest that the neurologic function of EAS was congenitally disturbed, and the current operative technique had no significant effect on the sphincter function.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anal Canal / abnormalities*
  • Anal Canal / innervation
  • Anal Canal / physiology*
  • Anal Canal / surgery*
  • Child
  • Child, Preschool
  • Electromyography
  • Humans
  • Infant
  • Lumbosacral Plexus / physiology
  • Magnetics* / instrumentation
  • Neural Conduction / physiology
  • Postoperative Period
  • Rectum / abnormalities*
  • Rectum / surgery*
  • Spinal Nerve Roots / physiology