Spinal abnormalities in classic bladder exstrophy

Objective To determine the frequency and clinical sequelae of significant spinal malformations in children born with classic bladder exstrophy. Patients and methods All patients evaluated or treated for classic bladder exstrophy at this institution were reviewed retrospectively. Radiographs or rep...

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Bibliographic Details
Published in:	British Journal of Urology Vol. 79; no. 6; pp. 975 - 978
Main Authors:	CADEDDU, J.A., BENSON, J.E., SILVER, R.I., LAKSHMANAN, Y., JEFFS, R.D., GEARHART, J.P.
Format:	Journal Article
Language:	English
Published:	Oxford, UK Blackwell Science Ltd 01-06-1997 Blackwell
Subjects:	Adolescent Adult Biological and medical sciences Bladder Exstrophy - etiology Child Child, Preschool Exstrophy Female Humans Infant Male Malformations of the urinary system Medical sciences Middle Aged Nephrology. Urinary tract diseases Retrospective Studies scoliosis Scoliosis - complications spinal dysraphism Spinal Dysraphism - complications Spine - abnormalities Urinary tract. Prostate gland vertebrae Human Nervous system diseases Urinary system disease Deformation Spine Diseases of the osteoarticular system Vesical exstrophy Spine disease Urinary tract disease Congenital disease Concomitant disease Malformation Scoliosis Central nervous system disease Bladder disease Diagnosis Child Spinal cord disease
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Summary:	Objective To determine the frequency and clinical sequelae of significant spinal malformations in children born with classic bladder exstrophy. Patients and methods All patients evaluated or treated for classic bladder exstrophy at this institution were reviewed retrospectively. Radiographs or reports pertinent to the spine were retrieved and reviewed with a paediatric radiologist and all vertebral abnormalities categorized. Clinical charts of those with spinal anomalies were reviewed to determine any clinical neurological disorders associated with the radiographic findings. Results Of 423 patients with classic bladder exstrophy who were identified, 299 had radiographs or reports available for adequate review. Of these, 34 (11%) normal variants, e.g. spina bifida occulta and lumbarization or sacralization of vertebrae, were identified. Abnormalities of spinal curvature were identified in eight patients (2.7%), all with uncomplicated scoliosis. Spinal dysraphism was diagnosed in 12 patients (4%) and included myelomeningocele, lipomeningocele, scimitar sacrum, posterior laminal defects in two or more vertebrae, vertebral fusion and hemivertebrae. The one patient with myelomeningocele had clinical neurological dysfunction, giving an overall incidence of 0.3%. Conclusions Spinal anomalies, excluding normal variants, occur in children born with classic bladder exstrophy at a rate of about 6.7%. The incidence of this association is much less than that for cloacal exstrophy. Although rare, neurological dysfunction can occur in the case of spinal dysraphism. Paediatric urologists and neurologists should be aware of this significant difference between patients with classic bladder and cloacal exstrophy to properly diagnose, evaluate and treat the attendant neurological problems.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0007-1331 1464-410X
DOI:	10.1046/j.1464-410X.1997.00190.x