=Abstract=

oj All t:Jl ~..Ji!. ..9.1:i1j- t:Jl ~ .2j:i1j-~ ..Ji!.AJ 5:: 0 }.2j .ie},

±;

~7} %'i:l~]t"}O:j ~Acl-'f-;;i(agenesis) , ~ 3:i4(hemi

vertebrae), 3:i 4-'6-7] ~ (vertebral arch deformities), ~.g. 784 ~ %4, £.4"-1 %l{l7] -~~s.. L}Eht T ,\)~L-l rB-'f-~.g. 7]i§0] ~.g-o]L} u].g-01] -;;-~

B 78 Sf-°lr::1- '. tiJr~ ;

Jl~ 71 ~ 170]1 'F 50]1 1::- Jti-* ~~% ~-"l~q. l1tB-ir-E-l J{lTI~ rz.g.. A1~t;-J~3J ;

0,9

0,8

o 0,7

~ 0,6 co 0,5 ~ 0,4 (/) 0,3

0,2

0,1

o Control High type Low type

ARM ARM

Fig. 2. Mean sacral ratio TSR ; true sacral ratio SCR ; sacrococcygeal ratio

*p

- i::0 }.213!J- All 6 l'l All 1 I 2000';1 -

Table 3 . Repetitive Measurements of Sacral Ra tio

Case TSR SCR Interval

1st 2nd 1st 2nd (m)

1 0.64 0 .66 0 .63 0.66 18

2 0 .58 0.57 0 .78 0 .76 46

3 0.54 0 .51 0 .74 0.76 50

4 0.60 0.46 0.60 0.68 3

5 0.50 0.48 0.68 0.65 4

6 0.65 0.58 0.65 0.73 27

7 0.69 0.67 0 .69 0.79 16

8 0.55 0 .53 0.73 0.78 6

9 0.48 0.45 0.48 0.45 31

10 0.47 0.39 0.47 0.39 15

11 0.49 0 .51 0 .49 0.51 29

12 0.48 0.56 0.48 0.71 25

13 0 .60 0 .59 0 .60 0 .59 24

p value 0 .149 0 .145

Case 1; Control group. Case 2- 7 ; Hirschsprung's disease. Case 8; low type ARM. Case 9- 13 : high type ARM

Table 4. Clinical Assessment of Anal Continence a nd Sacra l Ratio in High Type Anorectal Malformation Patients

Case Kelly ' s score

1 3

2 3

3 3

4 1

5 4

6 6

7 6

8 4

9 5

10 3

11 5

12 6

13 5

14 3

15 2

Correlation coefficient 0.371 (p = 0.173)

%01 ~ ).}%

'J .y ~).2..Y- cJ1-¥-~.g. 7] ~0] ;B~o]y- o]~oJ] ~~-t! 7ClJf--0]ql .

;B~7]~.g. a:]r:l 7}7-] tlJ~.2..~ ~*£]s;J,-c-L-n7- 11

Stanley %7.g. I) ~ "'j-¥-1i(agenesis, absent verte-bra) 2) Jti-~4-(dysgenesis, hemivertebrae) 3) %w

-¥-1i (dysraphism, deficiency of the neural arch) %

.2..~ ~*i5}~.2..Y-, 5:°}oJ] Al-c- ;B~oj AjS:;-i5}7-]

*5}0~ ~:§f~ ~7}7} ~c:jJf--uj ;B~7] ~0] ';)-c-

7ClJf--oJ]-c- 1:1",* 7Jl{!-~'i'l lIa7}7} ~c:jSf~ ;B~~ lIa

7}W .y ';)-C- tlJ~.9.J ~.R"'Jo] cJ1'¥-51s;J,q. 0] oj] Pena -c- -l'l--¥-lih:?'!t°a AJoJ] A1 ;B ~ 1:1] ~ ~ ~ 5}a:]

t!~.9.J AJ E!l ~ ~~i5}~-c-L-n , Pena9.1 ~T~J!j-oJH -c- ~AJO}9.1. ;B~I:I]-c- 0.74 o]~q. g:: ~J~~VJ7]

~ ¥lA9.1 ;B~I:I]-c- .:::r.!rl..q '7t.g. .y;;'] ~ .!rl..a:] 0]

-c- ~J~~?J7] ~ ¥lA9.1 7] ~~'i'l 01] ~~ %4-i5} -c-L-1] %%5}qJl .!rl..Jli5}~q2 .:::rr:1Y- Pena9.1 ~T -c- ~ AJo}9.1 ;B ~I:I ] ~ ~ 9.1 ~ tg oj Y- Zj- ~ tg oJ]Al

t!~1:I ] 7} %~~ 7H] r\1~ 7cl~ , ~ ¥l-A}oJ]Al A]

n nZl% '¥-Jl ;B~I:I]~ AH ~~ i5}~ ~ rrJl ;;.}o] 1J o] ';)~7}oJ] r\1~ ~~ ~ 0]~9.1 ~~AJE!l ~ ~~7-n tH~w ~'i'l7}oJ] r\1 ~ A~~o] :§f~;;'] ~.2..

E..~ ~ ~ToJ] Al-c- 0] oj] cJ1 ~ ~T~ ~"5~i5}~q.

g::~ ~ ~ToJ]Al-c- ~ ~9.1 7] ~0] {j5}a:] ~~I:I ]

~ ~ ~ i5} 7]7} ~ c:j -&- o1]-c- r\1 AJoJ] A1 A1].21 i5}~ -c-L-1] .:::r 0] %-c- ~ ~7] ~ 0] {j ~ 7Cl Jf---c- ~ ~ T9.1 tlJ~.2..~ ~~I:I] ~ ~~i5}7] 7} %0]i5}7-] ~~.2..uj,

~ ~T9.1 %%AJoj -l'l--¥-B-i:?'!t°a AJoJ]A1 ~7-n ~ ~.9.J 7] ~% ~ .y ';)-c- o1].!rl..q-c- 1:I ] .iil.~ ~AJ~ 'i'l £0J:9.1 ~~0] 7-] 'i1- ~~ ~s:..7} ~-"J.!rl..q-c- {} 5:~ o1]oJ]Al 1:-1 ,;)qJl A~Zj-517] rrJl ~ojs;J,q. ~

~J~~::

l'J--f?:- %A~ qP'J-.£.~ 7HI@7}7} ~R~ ?>:l.£.~ A~

Zf~y. ~.JJ.j-oJl Ll1 ~ iE-~-f?:- qg il-j- ~ol ~ 4'- ~ q.

:)!~H , "8"J-r~7-J-7 1 ~ ~A9.] "f-~ .f- tlH~7 1 ~-f?:"f-~ lclJ-tt) ~ "f-~oJl 9.] ~ ~17] ~ 9.] it-¥- % O:j ~~ 7}.A1 ~.A}7} W7Jl1 -'3f%ti}71 uJlroJl ~~1:I17} "8"J-lf-

~7-J-71 ~ %.A}9.] 71~~ a11 .f-~ a11~ti}';::' .AIR~

A}%~ 71 ~ "5H A1';::' q~ 7-} iE-~01 ~R~ ?>:l.£.~

A}li!8q.

~~, ~~1:I1 7} "8"J-lf-~ 7-J-7 1 ~ %7-}9.] a11.f-.2} ~

~~~ AJ-~ ~1117} ~71 .!x!.q,;::, ~~tlI 7} R-f?:-

%7-}oJ1 Al 1:IHl(! 71~01 '?!~.A-~7-1 *~ uJl 7HI@7}

9.] .3j5:.~Al ~%~ "f- ~qJl A~Zf!8q. "8"J-lf-~AJ-

717@ %7-}9.] .f-~lclJ-"8"J-lf-~ AJAj 7@~ .f- tlHl(!71~oJl 7-JoH 7} ~~ %.A}oJIAl 7H4'-~~ Ali;~~ ~.JJ.j- ~~

tl1 7} 3't~"f-~ 7H"f-~9.] ~.JJ.j-7} ~~q.;::. .!2.Jl7}

~q2. Ef.~ ~~tl17} ';;t~ "8"J-lf-~AJ71~ %7-}';::' tethered cord7} ~ ~ 7}~Ajol 3't71 uJl -lf-oJl ~~tll

7} OA 0lti}~ 7d-¥- .3j"f-71~% ~A}ti}';::' ?>:l0l ~ .£. oj, .iil ~ 7}~ ~ .3j 4'-9.] 17] l(! -f?:- .iil-?] ti}.;::. ?>:l ° I

"6"Jr~7-J717@ % 7-}9.] -*-llioJl 5:.%°1 !8q.;::. .!x!.Jl 7} ~q15. 16 .

°VJoJ1 Al.2} {f°l ~~tll';::' :J. *%-"jol A~l~~

elY. 11711 ~~~ "f- ~.£.E..~ 'i:lAJ-~.£.~ 9.] 01 ~~ ~A}tt)°le.}Jl -"}li!8q.

7-1.A}~~ ~~ ~0}oJ1 Al ~~tll~ ~-,,}~ tl} tlH

l(!71~oJl AJoij 7} ~.;::. -?]AJ-°}oJJAl ~~~1:Il';::' 0.60

± 0.08 0l~.£.oj ~01~1:Il ';::' 0.72 ± 0.13 0l~q. ~

~tll.2} 'i'!tg.JJ.j-~ *111~ .£.~ AJ-~~1117} ~~.£.oj

{f~ %.A}oJ1Al ~* ~~!8 ~~tll 5:. 'i'!tgoJl rrj-e.}

*9.]~ -*-}ol ~ .!x!.°I .Al ~o} 'i'!tgoJl rrj-~ ~~tll9.]

l(!::&~ *111~.£.~ 9.] 017} ~~q. "8"J--lf-~AJ717@

%.A} ~ 7-1~"6"Jr~7-J71~ %7-}9.] ~~tll ';::' -?]AJ-

0}.2} *9.]~ -*-}01 7} ~~li:! ~\'1oJ], Jl~"6"J-lf-~7-J

71~ %7-}9.] ~~tll';::' ~~~tll OA5 ±0.09, ~ol

~tll OA8 ±0. 11~ ~AJo}9.] ~~tll.2} *9.]~ -*-}ol

~ .!x!.O:j(p

A: Neuroradiologic evaluation of sacral abnor-

malities in imperforate anus complex. J Pe-

diatr Surg 22:58-61, 1987

15. Levitt MA, Patel M, Rodriguez G, Gaylin

DS, Pena A: The tethered spinal cord in pati-

ents with anorectal malformation.

Surg 32:462-468, 1997

Pediatr

16. Tsakayannis DE, Shamberger RC: Association

of imperforate anus with occult spinal dysra-

phism. J Pediatr Surg 30:1010-1012, 1995

- 39-