Ultrasonographic Evaluation of the Sacrococcyx and Spinal Canal in Children with Constipation

Background The occult neurological disorders are an important cause of constipation in children. This study aimed to evaluate the spinal canal and lumbosacral by ultrasound in pediatric constipation to better identifying neurological causes of constipation. Materials and Methods In this case-control study, 100 children with constipation (age range 1 to 14 years) without previously known chronic illness referred to the Radiology Department of the Mashhad Pediatric Dr. Sheikh Hospital were selected. After recording clinical data, the patients were undergone sacral and spinal cord ultrasound examinations and the results were compared with the control group (healthy children with transient illness (otherwise constipation or urinary disorders) who had referred to radiology department for sonographic examination). Results The mean age of patients was 6 ± 3.3 years old. The tethered cord and occult intrasacral meningocele were observed in 2% of patients group. Spina bifida was found in 64% patients, and 31% control subjects with significant difference (P = 0.009). About one third of cases with spina bifida were found in lumbar L5 vertebra, and another two third were in high sacral vertebrae (S1 or S2). Various degrees of caudal regression were observed in 8% patients suffering from constipation and in control group, 2% children had coccyx hypoplasia. No significant correlation was found between case and control groups regarding the location of spina bifida and non-formation of the posterior arch of the sacrum, the mean coccyx length, dural diameter and the ossification age of first vertebra of coccyx. Conclusion In pediatric age, lumbosacral spinal anomalies can easily evaluate with ultrasound. The prevalence of spina bifida and caudal regression in children with constipation was significantly higher compared with normal control group. 

Keywords:

Children , Constipation , Neurologic cause , Ultrasound