Spinal Congenital Dermal Sinuses: A 30-Year Experience
- 1 September 2003
- journal article
- Published by American Academy of Pediatrics (AAP) in Pediatrics
- Vol. 112 (3), 641-647
- https://doi.org/10.1542/peds.112.3.641
Abstract
Objective. Dermal sinus tracts are an uncommon form of spinal dysraphism often presenting in childhood with skin findings, neurologic deficit, or infection. We reviewed our surgical experience, examining presenting symptomatology, operative findings, and patient outcomes. Methods. A retrospective analysis of operated dermal sinus tract cases by the senior author (A.H.M.) from 1970 to present was made. Results. Twenty-eight patients were identified; 17 female and 11 male. Five cervical, 4 thoracic, 9 lumbar, and 9 lumbosacral tracts were explored. Sixteen patients presented at 1 year. Reasons for referral included cutaneous findings (15), neurologic deficit (8), foot abnormalities (4), infection (3), pain (2), and scoliosis (1). Our initial examination revealed cutaneous findings (eg, sinus ostea, pigmentation changes, erythema, skin tags, subcutaneous masses) in 27 patients and neurologic deficit in 19. Age-related differences were apparent. Patients >1 year were more likely to have neurologic deficit (92%) as compared with those Conclusions. Although most patients were referred for cutaneous stigmata evaluation, >50% had neurologic deficit, intradural tumors, or tethered cords. Skin findings identification should initiate prompt radiologic evaluation and neurosurgical intervention with intradural exploration. Timely intervention may preserve or improve neurologic function in these patients.Keywords
This publication has 18 references indexed in Scilit:
- Cervical and Thoracic Dermal Sinus TractsPediatric Neurosurgery, 2002
- Delayed postoperative tethering of the cervical spinal cordJournal of Neurosurgery, 1994
- Split Cord MalformationNeurosurgery, 1992
- Tethered cervical spinal cordJournal of Neurosurgery, 1987
- Epidermoid cyst occurring within a lumbosacral myelomeningoceleJournal of Neurosurgery, 1983
- Spinal Dysraphism in the Cervical and Dorsal Regions in ChildhoodPediatric Neurosurgery, 1982
- A prospective search for congenital dermal abnormalities of the craniospinal axisThe Journal of Pediatrics, 1975
- Occult spinal dysraphism: Diagnosis and managementThe Journal of Pediatrics, 1968
- Four Congenital Tumors Found at Operation Within the Vertebral CanalJournal of Neurosurgery, 1950
- CONGENITAL DERMAL SINUSES: A SOURCE OF SPINAL MENINGEAL INFECTION AND SUBDURAL ABSCESSESBrain, 1934