The purpose of this study is to determine if the development of idiopathic scoliosis is related to neuropathic detrusor/sphincter dyssynergia. When bladder and sphincter function are disturbed, adequate therapy can be started in an early phase to…
ID
Source
Brief title
Condition
- Spinal cord and nerve root disorders
- Bladder and bladder neck disorders (excl calculi)
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
The outcome parameters of this study are:
a) normal bladder/sphincter function;
b) bladder/sphincter dysfunction (detrusor/sphincter dyssynergia).
Based upon literature, we expect that the children in our study group will show
urological problems: probably 20% will have bladder/sphincter dyssynergia. In
the normal paediatric population between 10 and 16 years old (= reference
group), this percentage is 6%.
In our analysis, we will compare the percentage of bladder/sphincter
dyssynergia in both groups by using the binomial test.
Secondary outcome
Not applicable.
Background summary
Recently, it has been hypothesized that the longitudinal growth of the spinal
cord fails to keep pace with the growth of the vertebral column, and the
idiopathic scoliosis was a consequence of the maladaption of the growing
immature spine to a tether created by a short spinal cord.
When this theory holds true, this abnormal stretching can cause small lesions
of the spinal cord and the roots of the sacral nerves. These lesions can result
in neurologic defecit, known as symptomatic tethered cord or tethered cord
syndrome (TCS). The majority of patients with TCS (71%) presents with urinary
incontinence as a consequence of neuropathic detrusor/sphincter dysfunction
(also called detrusor/sphincter dyssynergia).
Functional tethering of the spinal cord cannot be demonstrated with magnetic
resonance imaging (MRI). In daily practice, children with idiopathic scoliosis
are not referred to an urologist, because in most cases there are no clear
indications of urological problems. However, when this new theory holds true
and functional tethering of the spinal cord plays a role in the development of
idiopathic scoliosis, functioning of the bladder and external sphincter
probably will be slightly disturbed, but children do not have complaints in an
early phase (subclinical changes). To demonstrate subclinical changes in
bladder/sphincter function additional urodynamic information is necessary.
Study objective
The purpose of this study is to determine if the development of idiopathic
scoliosis is related to neuropathic detrusor/sphincter dyssynergia. When
bladder and sphincter function are disturbed, adequate therapy can be started
in an early phase to preserve the patient from having urological problems in
the future.
Study design
Analysis of detrusor sphincter dyssynergia in children with adolescent
idiopathic scoliosis (AIS) using urinary flowmetry and echography of the lower
abdomen.
Study burden and risks
No significant health risks are associated with urinary flowmetry and
echography of the lower abdomen.
Heidelberglaan 100
3508 GA Utrecht
Nederland
Heidelberglaan 100
3508 GA Utrecht
Nederland
Listed location countries
Age
Inclusion criteria
Adolescent Idiopathic Scoliosis (AIS)
Exclusion criteria
No exclusion criteria.
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL12450.041.06 |