Impact of spinal cord anomalies on defecation and quality of life in children with anorectal malformations
Objective To explore the relationship between postoperative defecation dysfunction and quality of life in children with anorectal malformation (ARM) complicated with spinal cord anomalies (SCA) and analyze the impact of different types of SCA on ARM patients in order to provide a reference for the...
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Editorial Office of Journal of Army Medical University
2025-06-01
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| Series: | 陆军军医大学学报 |
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| Online Access: | https://aammt.tmmu.edu.cn/html/202503028.html |
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| author | FAN Linxiao FENG Wei XIANG Chenzhu |
| author_facet | FAN Linxiao FENG Wei XIANG Chenzhu |
| author_sort | FAN Linxiao |
| collection | DOAJ |
| description | Objective To explore the relationship between postoperative defecation dysfunction and quality of life in children with anorectal malformation (ARM) complicated with spinal cord anomalies (SCA) and analyze the impact of different types of SCA on ARM patients in order to provide a reference for the early clinical identification of high-risk children with poor prognosis. Methods A retrospective analysis was conducted on 282 ARM neonates admitted to our department between June 2015 and April 2021. Radiological examinations were applied to evaluate the development of the spinal cord, and Rintala score and the PedsQL 4.0 scale were employed to assess postoperative defecation function and quality of life, respectively. According to their SCA types and other complications, the patients were grouped. The relationship between these factors and defecation function as well as quality of life was then analyzed. Results Among the 282 subjected children, 104 (36.9%) had SCA. The incidence of SCA varied significantly across different types of ARM (P=0.002), with the highest incidence observed in vaginal fistula patients (100.0%) and the lowest in children without fistula (13.6%). Radiological findings revealed that sacral bone anomalies were common, with absent coccyx (62.7%) and vertebral anomalies (69.8%) being the most prevalent. The SCA group had significantly lower Rintala bowel function score (12.70±3.24) and PedsQL 4.0 quality of life score (81.42±5.03) than the non-SCA group (P<0.001). As the increment of SCA types, both the Rintala score and PedsQL 4.0 score were in a significant downward trend (P<0.001). Among the children with different types of SCA, those with tethered cord syndrome had the statistically lowest Rintala score (8.05±2.35, P<0.05). Meanwhile, their PedsQL 4.0 score (75.90±3.35) was significantly lower than those of other types except syrinx (P<0.05). Multiple linear regression analysis indicated that both SCA and sacral bone anomalies exerted notably negative impacts on the Rintala score and PedsQL 4.0 score (P≤0.001), with SCA having the most pronounced effect. Conclusion SCA is closely associated with postoperative defecation dysfunction and diminished quality of life in ARM children. The greater the type and number of SCAs, the worse the postoperative defecation function and quality of life. Early identification of concomitant SCAs holds significant clinical value for predicting postoperative outcomes in ARM patients.
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| format | Article |
| id | doaj-art-16b7f34c6a794c8594323e48f6e294a2 |
| institution | Matheson Library |
| issn | 2097-0927 |
| language | zho |
| publishDate | 2025-06-01 |
| publisher | Editorial Office of Journal of Army Medical University |
| record_format | Article |
| series | 陆军军医大学学报 |
| spelling | doaj-art-16b7f34c6a794c8594323e48f6e294a22025-06-26T09:42:44ZzhoEditorial Office of Journal of Army Medical University陆军军医大学学报2097-09272025-06-0147121350135710.16016/j.2097-0927.202503028Impact of spinal cord anomalies on defecation and quality of life in children with anorectal malformationsFAN Linxiao0FENG Wei1XIANG Chenzhu2Department of General & Neonatal Surgery， National Clinical Research Center for Child Health and Disorders， Key Laboratory of Child Development and Disorders of Ministry of Education， Chongqing Key Laboratory of Pediatrics， Children’s Hospital of Chongqing Medical University， Chongqing， ChinaDepartment of General & Neonatal Surgery， National Clinical Research Center for Child Health and Disorders， Key Laboratory of Child Development and Disorders of Ministry of Education， Chongqing Key Laboratory of Pediatrics， Children’s Hospital of Chongqing Medical University， Chongqing， ChinaDepartment of General & Neonatal Surgery， National Clinical Research Center for Child Health and Disorders， Key Laboratory of Child Development and Disorders of Ministry of Education， Chongqing Key Laboratory of Pediatrics， Children’s Hospital of Chongqing Medical University， Chongqing， ChinaObjective To explore the relationship between postoperative defecation dysfunction and quality of life in children with anorectal malformation (ARM) complicated with spinal cord anomalies (SCA) and analyze the impact of different types of SCA on ARM patients in order to provide a reference for the early clinical identification of high-risk children with poor prognosis. Methods A retrospective analysis was conducted on 282 ARM neonates admitted to our department between June 2015 and April 2021. Radiological examinations were applied to evaluate the development of the spinal cord, and Rintala score and the PedsQL 4.0 scale were employed to assess postoperative defecation function and quality of life, respectively. According to their SCA types and other complications, the patients were grouped. The relationship between these factors and defecation function as well as quality of life was then analyzed. Results Among the 282 subjected children, 104 (36.9%) had SCA. The incidence of SCA varied significantly across different types of ARM (P=0.002), with the highest incidence observed in vaginal fistula patients (100.0%) and the lowest in children without fistula (13.6%). Radiological findings revealed that sacral bone anomalies were common, with absent coccyx (62.7%) and vertebral anomalies (69.8%) being the most prevalent. The SCA group had significantly lower Rintala bowel function score (12.70±3.24) and PedsQL 4.0 quality of life score (81.42±5.03) than the non-SCA group (P<0.001). As the increment of SCA types, both the Rintala score and PedsQL 4.0 score were in a significant downward trend (P<0.001). Among the children with different types of SCA, those with tethered cord syndrome had the statistically lowest Rintala score (8.05±2.35, P<0.05). Meanwhile, their PedsQL 4.0 score (75.90±3.35) was significantly lower than those of other types except syrinx (P<0.05). Multiple linear regression analysis indicated that both SCA and sacral bone anomalies exerted notably negative impacts on the Rintala score and PedsQL 4.0 score (P≤0.001), with SCA having the most pronounced effect. Conclusion SCA is closely associated with postoperative defecation dysfunction and diminished quality of life in ARM children. The greater the type and number of SCAs, the worse the postoperative defecation function and quality of life. Early identification of concomitant SCAs holds significant clinical value for predicting postoperative outcomes in ARM patients. https://aammt.tmmu.edu.cn/html/202503028.htmlcongenital anorectal malformationspinal cord anomaliesdefecation dysfunctionquality of life |
| spellingShingle | FAN Linxiao FENG Wei XIANG Chenzhu Impact of spinal cord anomalies on defecation and quality of life in children with anorectal malformations 陆军军医大学学报 congenital anorectal malformation spinal cord anomalies defecation dysfunction quality of life |
| title | Impact of spinal cord anomalies on defecation and quality of life in children with anorectal malformations |
| title_full | Impact of spinal cord anomalies on defecation and quality of life in children with anorectal malformations |
| title_fullStr | Impact of spinal cord anomalies on defecation and quality of life in children with anorectal malformations |
| title_full_unstemmed | Impact of spinal cord anomalies on defecation and quality of life in children with anorectal malformations |
| title_short | Impact of spinal cord anomalies on defecation and quality of life in children with anorectal malformations |
| title_sort | impact of spinal cord anomalies on defecation and quality of life in children with anorectal malformations |
| topic | congenital anorectal malformation spinal cord anomalies defecation dysfunction quality of life |
| url | https://aammt.tmmu.edu.cn/html/202503028.html |
| work_keys_str_mv | AT fanlinxiao impactofspinalcordanomaliesondefecationandqualityoflifeinchildrenwithanorectalmalformations AT fengwei impactofspinalcordanomaliesondefecationandqualityoflifeinchildrenwithanorectalmalformations AT xiangchenzhu impactofspinalcordanomaliesondefecationandqualityoflifeinchildrenwithanorectalmalformations |