Congenital spinal dermal sinuses: poor awareness leads to delayed treatment

Abstract

Primary care physicians should be made more aware about congenital spinal dermal sinuses. This will facilitate early diagnosis and referral to specialist services.

Catastrophic Intramedullary Abscess Caused by a Missed Congenital Dermal Sinus

“…The outcome may depend on the degree of septic involvement of the spinal cord and the time to diagnosis and surgical intervention. In the series of Ramnarayan et al 10) , all patients over the age of 1 year had purulent infection or neurological deficits at presentation, and surgical morbidity paralleled the time interval to definitive treatment. Our patient had partial recovery of neurological deficits after treatment and rehabilitation.…”

“…However, erroneous information is still widespread and a decision-making mistake may lead to irreversible damage to the patient 4) . Ramnarayan et al 10) reported a clinical course of 9 patients with CDS. Interestingly, all the patients were previously examined by medical personnel (family doctor, pediatrician, or general practitioner) and they made no action or gave just empirical treatment with antibiotics before significant neurological deficits or meningitis developed.…”

Congenital inclusion tumours in spinal dysraphism

“…Even partial/ near total removal can be gratifying and provide the child many years or even permanent freedom from progressive disturbances. 9 Besides anecdotal case reports highlighting various facets of CIT with spinal dysraphism, Shikata (1988), Lunardi (1989) 9 , Kumar (1990), Ackerman (2003) 5 , Rajkumar (2003) 10 and Ramnarayan (2006) 8 have reported between 2-7 cases of CIT in children, mostly dermoids, a few of these associated with spinal dysraphism. The diagnosis, management and outcome in the present study have been similar to the few previously reported short series.…”

“…In Cases 1-4, a multitude of social reasons account for the time elapsed between the initial presentation and definitive surgery and reflects the problems with early diagnosis and management of these entities in a developing country. 8 Bony vertebral anomalies may or may not be evident on plain radiograph, a MRI is mandatory to clarify the diagnosis and facilitate surgical decisions. Related spinal anomalies evident on MRI include spondylolisthesis, syringomyelia, diastemetamyelia and low lying conus.…”

Congenital Spinal Dermal Sinuses Long-Term Analysis at King Hussein Medical Center

“…These sinuses end blindly with no extension so it is not necessary to perform a radiological evaluation. The operation only needed if the background of the sinuses not displayed, to prevent future infections (1) Many publications on spinal dermal sinuses, emphasized that despite their benign external appearance, these lesions are capable of producing serious neurologic deficits disease due to meningitis, spinal cord compression, and infected dermoid cysts, as occurred in a large part of our cases (5)(6)(7)(8)(9) Medical records of our patients with dermal sinuses were analyzed and revealed 53-cases.All had a cutaneous orifice in the mid line Figure 2 . Regarding the anatomical segment involved our results compared to what has been reported in the literature (3,10 ,15) Results are shown in the chart Figure1.…”