Tethered spinal cord syndrome detected during ultrasound for caudal block in a child with single urological anomaly


Corresponding author: Hae Keum Kil, M.D., Department of Anesthesiology and Pain Medicine, and Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50, Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. Tel: 82-2-2228-2420, Fax: 82-2-312-7185, E-mail: hkkil@yuhs.ac This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. CC With the increasing use of ultrasound for assuring safe and accurate caudal or epidural block for postoperative analgesia in children, hidden spinal dysraphism may be found in cidentally. Children with congenital anomalies such as VATER or VACTERL frequently present with accompanying occult spinal dysraphisms (OSD), which is characterized with skincovered lesions such as tethered spinal cord (TSC), meningocele, or lipomyelomeningocele. OSDs are usually found incidentally during the evaluation for other diseases or after neurological symptoms manifest. However, in children with a simple urogenital anomaly, OSD may not be found until the symptoms of OSD manifest because ultrasound screening is not routinely performed in neonates. We report a case of TSC that was discovered during routine ultrasound for caudal block in an asymptomatic child undergoing urological surgery. A 12-month-old, 9.8 kg, otherwise healthy female infant was


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