40:
303:
surgical removal of the congenital dermal sinus tract is beneficial for the patient, allowing neurological and bladder function to be maintained. Early surgical intervention results decreases the risk of infection and/or tumour progression â factors typically associated with delayed presentation of
275:(MRI) is the preferred tool for diagnostic and preoperative imaging of congenital dermal sinus. MRI allows the neural structures to be observed, visualizing the tract and its anomalies and lesions. For example, exposing tethered cord, inclusion tumors or spinal cord malformations. Observation by
307:
The surgical technique involves âremoving the cutaneous lesion in ellipseâ. The tract of the congenital dermal sinus must then be explored and excised, with intradural lesions dissected. If not all epithelial tissue is removed, there is a possibility for the dermoid cyst to reoccur and require
316:
Prior to pervasive use and availability of advanced methods of neuroimaging, it is possible that the rate of incidence of congenital dermal sinus has been supplemented by the incidence of coccygeal pits. Coccygeal pits are distinct from congenital dermal sinus as they are found within the
325:
orientated coccygeal pits are not associated with intradural pathology and do not need to be excised, unlike the cephalically oriented tracts of the congenital dermal sinus which confer great intradural pathology and require surgical intervention. While coccygeal pits occur in 4% of
1042:
128:. In cases of congenital dermal sinus there is a failure in this process, resulting in formation of a persistent connection between the skin and neural tissue. This manifests as a tract extending from the surface of the skin to the spinal cord lined with
756:
1035:
1028:
136:, or even make contact with neural elements. Congenital dermal sinus may form at any point along the midline of the neuraxis, however, the majority form in the lumbar and lumbosacral region (41% and 35% of cases respectively).
749:
95:
Early diagnosis and treatment is crucial for cases of congenital dermal sinus. It ensures that neurological condition does not degrade and prevents infection. Diagnosis can be confirmed through the use of advanced
742:
304:
congenital dermal sinus. ] Intradural exploration is necessary as excision of the entire tract, as well as any of its intradural connections, reduces need for further surgical intervention.
1729:
160:
Congenital dermal sinus is a tract from the surface layer of the skin, through the deeper tissues into the cranial or spinal cavity. The skin findings of this tract can include:
1724:
264:
dysfunction, as well as compressing the spine. Neurological deficits are more likely to occur where diagnosis has not been timely, allowing cysts and or infection.
64:
and often presents alongside infection and neurological deficit. Congenital dermal sinus form due to a focal failure of dysjunction between the cutaneous
1622:
152:. Early diagnosis is important in congenital dermal sinus, so that treatment can be provided early, to prevent progression of associated complications.
687:
Szmyd, B; Jabbar, R; Lusa, W; Karuga, FF; Pawelczyk, A; Blaszczyk, M; Jankowski, J; Solek, J; Wysiadecki, G; Tubbs, R.S.; Iwanaga, J; Radek, M (2022).
657:
347:
Szmyd, B; Jabbar, R; Lusa, W; Karuga, FF; Pawelczyk, A; Blaszczyk, M; Jankowski, J; Solek, J; Wysiadecki, G; Tubbs, R.S.; Iwanaga, J; Radek, M (2022).
1115:
1020:
1734:
941:
1563:
1517:
1236:
893:
129:
1352:
244:
tethering; conveying neurological deficit. Neurological deficit can occur due to spinal cord compression from intradural
1055:
1522:
1241:
1071:
1059:
916:
1553:
272:
1607:
850:
47:
The schematic representation of a dermal tract as a predisposing factor for intramedullary spinal cord abscesses.
1527:
216:. Thus, the congenital dermal sinus forms a point of entry for infection, this can allow for the formation of an
1462:
1105:
734:
1499:
1133:
1110:
1402:
1067:
898:
60:. It occurs in 1 in 2500 live births. It occurs as a dermal indentation, found along the midline of the
514:
Ackerman, LL; Menezes, AH (September 2003). "Spinal congenital dermal sinuses: a 30-year experience".
39:
1617:
1435:
1051:
824:
765:
689:"What Is Currently Known about Intramedullary Spinal Cord Abscess among Children? A Concise Review"
349:"What Is Currently Known about Intramedullary Spinal Cord Abscess among Children? A Concise Review"
296:
124:. That is, the skin separates from the tissue of the spinal cord to allow proper formation of the
1297:
995:
966:
908:
874:
786:
204:
The stratified squamous epithelium of the congenital dermal sinus tract can extend to the spinal
308:
further operation. Further operations are limited by postoperative and post-infection scarring.
1632:
1612:
864:
720:
669:
619:
531:
445:
430:
380:
57:
1679:
1674:
1595:
1587:
1507:
1471:
1279:
1231:
1188:
1000:
710:
700:
609:
523:
370:
360:
125:
1695:
1430:
1260:
1226:
1179:
884:
1558:
1489:
1453:
1425:
1347:
1251:
1125:
936:
927:
903:
769:
715:
688:
375:
348:
220:, especially among children. Infection can then travel up the spinal cord to result in
173:
1718:
1568:
1512:
1479:
1362:
1183:
1005:
869:
845:
819:
318:
284:
280:
117:
69:
1650:
1543:
1385:
1357:
1143:
1138:
979:
974:
922:
840:
812:
300:
245:
233:
97:
1573:
1340:
1331:
1216:
1148:
957:
794:
777:
241:
213:
133:
81:
132:, surrounded by dermal and neurological tissue. The tract may terminate in the
1548:
1484:
1397:
1391:
1367:
1335:
1302:
1271:
1221:
1193:
879:
221:
209:
168:
283:
of infants less than 18 months. X-ray may be used in conjunction with MRI or
1655:
1600:
1407:
1292:
1285:
1266:
1198:
1162:
807:
614:
597:
330:
population, congenital dermal sinus is only found in 1 in 2500 live births.
261:
249:
193:
73:
724:
673:
623:
535:
527:
449:
384:
1097:
1093:
1075:
322:
178:
149:
121:
113:
65:
61:
705:
658:"Spinal congenital dermal sinus: an experience of 23 cases over 7 years"
365:
1665:
1323:
802:
327:
217:
145:
101:
89:
253:
205:
187:
85:
77:
431:"Infected spinal dermal sinus tract with meningitis: a case report"
276:
237:
1208:
257:
1024:
738:
16:
Birth defect; indentation along the spine and base of the skull
1641:
1171:
1084:
295:
Treatment of congenital dermal sinus involves complete
232:
Congenital dermal sinus is often also associated with
279:
is limited in diagnosis, especially due to immature
1688:
1664:
1640:
1631:
1586:
1536:
1498:
1470:
1461:
1452:
1418:
1378:
1322:
1315:
1250:
1207:
1170:
1161:
1124:
1092:
1083:
1066:
988:
965:
956:
833:
785:
776:
84:region, congenital dermal sinus can occur from the
29:
24:
429:Wang, YM; Chuang, MJ; Cheng, MH (September 2011).
299:of the tract as well as intradural exploration.
1730:Congenital disorders of musculoskeletal system
144:Congenital dermal sinus is often diagnosed in
1036:
750:
8:
656:Jindal, A; Mahapatra, AK (September 2001).
321:, rather than above the gluteal cleft. The
1637:
1467:
1458:
1319:
1167:
1089:
1080:
1043:
1029:
1021:
962:
782:
757:
743:
735:
21:
714:
704:
613:
374:
364:
224:, which can be fatal if left untreated.
942:Bilateral frontoparietal polymicrogyria
339:
1725:Congenital disorders of nervous system
256:. Tethered spinal cord can result in
112:During normal development, cutaneous
7:
1564:Greig cephalopolysyndactyly syndrome
596:Elton, S; Oakes, JW (January 2001).
591:
589:
587:
585:
583:
581:
579:
577:
575:
573:
571:
569:
567:
565:
509:
507:
505:
503:
501:
499:
497:
495:
493:
491:
489:
487:
485:
483:
481:
479:
424:
422:
420:
418:
416:
414:
100:to observe the tract and associated
651:
649:
647:
645:
643:
641:
639:
637:
635:
633:
563:
561:
559:
557:
555:
553:
551:
549:
547:
545:
477:
475:
473:
471:
469:
467:
465:
463:
461:
459:
412:
410:
408:
406:
404:
402:
400:
398:
396:
394:
1054:malformations and deformations of
768:malformations and deformations of
598:"Dermal sinus tracts of the spine"
72:during the third to eight week of
56:is an uncommon form of cranial or
14:
287:images to assist preoperatively.
38:
1237:Congenital patellar dislocation
1116:WallisâZieffâGoldblatt syndrome
894:Agenesis of the corpus callosum
1735:Cutaneous congenital anomalies
130:stratified squamous epithelium
120:to allow for the insertion of
33:Spinal congenital dermal sinus
1:
693:Journal of Clinical Medicine
353:Journal of Clinical Medicine
76:. Typically observed in the
1523:Oto-palato-digital syndrome
1518:HallermannâStreiff syndrome
1242:Congenital knee dislocation
1060:musculoskeletal abnormality
860:other reduction deformities
1751:
1554:Craniodiaphyseal dysplasia
438:Acta Neurologica Taiwanica
273:Magnetic Resonance Imaging
1528:Treacher Collins syndrome
1379:reduction deficits / limb
46:
37:
1353:CenaniâLenz syndactylism
1106:Cleidocranial dysostosis
846:Congenital hydrocephalus
1500:Craniofacial dysostosis
615:10.3171/foc.2001.10.1.5
156:Cutaneous abnormalities
54:Congenital dermal sinus
25:Congenital dermal sinus
1056:musculoskeletal system
528:10.1542/peds.112.3.641
212:or all the way to the
1608:KlippelâFeil syndrome
899:Septo-optic dysplasia
851:DandyâWalker syndrome
236:drainage, intradural
183:Abnormal pigmentation
1618:Spina bifida occulta
1134:Madelung's deformity
1111:Sprengel's deformity
228:Neurological deficit
1436:RAPADILINO syndrome
825:Chiari malformation
706:10.3390/jcm11154549
602:Neurosurgical Focus
366:10.3390/jcm11154549
1298:Rocker bottom foot
996:Currarino syndrome
967:Neural tube defect
909:Hemimegalencephaly
875:Microlissencephaly
787:Neural tube defect
164:Pit along neuraxis
1712:
1711:
1708:
1707:
1704:
1703:
1633:Thoracic skeleton
1613:Spondylolisthesis
1582:
1581:
1448:
1447:
1444:
1443:
1311:
1310:
1157:
1156:
1018:
1017:
1014:
1013:
952:
951:
865:Holoprosencephaly
522:(3 Pt 1): 641â7.
260:difficulties and
58:spinal dysraphism
51:
50:
19:Medical condition
1742:
1680:Pectus carinatum
1675:Pectus excavatum
1638:
1596:Spinal curvature
1588:Vertebral column
1508:Crouzon syndrome
1472:Craniosynostosis
1468:
1459:
1324:fingers and toes
1320:
1232:Discoid meniscus
1189:Upington disease
1168:
1090:
1081:
1045:
1038:
1031:
1022:
1001:Diastomatomyelia
963:
783:
759:
752:
745:
736:
729:
728:
718:
708:
684:
678:
677:
653:
628:
627:
617:
593:
540:
539:
511:
454:
453:
435:
426:
389:
388:
378:
368:
344:
126:vertebral column
42:
22:
1750:
1749:
1745:
1744:
1743:
1741:
1740:
1739:
1715:
1714:
1713:
1700:
1696:Poland syndrome
1684:
1660:
1627:
1578:
1532:
1494:
1440:
1431:Larsen syndrome
1419:multiple joints
1414:
1374:
1307:
1246:
1227:Genu recurvatum
1203:
1180:Hip dislocation
1153:
1120:
1070:
1062:
1049:
1019:
1010:
984:
948:
885:Hydranencephaly
829:
772:
763:
733:
732:
686:
685:
681:
662:Neurology India
655:
654:
631:
595:
594:
543:
513:
512:
457:
433:
428:
427:
392:
346:
345:
341:
336:
314:
293:
270:
230:
202:
192:Signs of local
167:Flat capillary
158:
142:
116:separates from
110:
20:
17:
12:
11:
5:
1748:
1746:
1738:
1737:
1732:
1727:
1717:
1716:
1710:
1709:
1706:
1705:
1702:
1701:
1699:
1698:
1692:
1690:
1686:
1685:
1683:
1682:
1677:
1671:
1669:
1662:
1661:
1659:
1658:
1653:
1647:
1645:
1635:
1629:
1628:
1626:
1625:
1620:
1615:
1610:
1605:
1604:
1603:
1592:
1590:
1584:
1583:
1580:
1579:
1577:
1576:
1571:
1566:
1561:
1559:Dolichocephaly
1556:
1551:
1546:
1540:
1538:
1534:
1533:
1531:
1530:
1525:
1520:
1515:
1510:
1504:
1502:
1496:
1495:
1493:
1492:
1490:Trigonocephaly
1487:
1482:
1476:
1474:
1465:
1463:Skull and face
1456:
1450:
1449:
1446:
1445:
1442:
1441:
1439:
1438:
1433:
1428:
1426:Arthrogryposis
1422:
1420:
1416:
1415:
1413:
1412:
1411:
1410:
1405:
1400:
1388:
1382:
1380:
1376:
1375:
1373:
1372:
1371:
1370:
1360:
1355:
1350:
1348:Arachnodactyly
1345:
1344:
1343:
1328:
1326:
1317:
1313:
1312:
1309:
1308:
1306:
1305:
1300:
1295:
1290:
1289:
1288:
1276:
1275:
1274:
1269:
1256:
1254:
1252:foot deformity
1248:
1247:
1245:
1244:
1239:
1234:
1229:
1224:
1219:
1213:
1211:
1205:
1204:
1202:
1201:
1196:
1191:
1186:
1176:
1174:
1165:
1159:
1158:
1155:
1154:
1152:
1151:
1146:
1141:
1136:
1130:
1128:
1126:hand deformity
1122:
1121:
1119:
1118:
1113:
1108:
1102:
1100:
1087:
1078:
1064:
1063:
1050:
1048:
1047:
1040:
1033:
1025:
1016:
1015:
1012:
1011:
1009:
1008:
1003:
998:
992:
990:
986:
985:
983:
982:
977:
971:
969:
960:
954:
953:
950:
949:
947:
946:
945:
944:
937:Polymicrogyria
933:
932:
931:
930:
928:Schizencephaly
925:
912:
911:
906:
904:Megalencephaly
901:
896:
890:
889:
888:
887:
882:
877:
872:
867:
856:
855:
854:
853:
843:
837:
835:
831:
830:
828:
827:
822:
817:
816:
815:
810:
805:
800:
791:
789:
780:
774:
773:
770:nervous system
764:
762:
761:
754:
747:
739:
731:
730:
679:
629:
541:
455:
390:
338:
337:
335:
332:
313:
310:
292:
289:
269:
266:
248:growth in the
229:
226:
201:
198:
197:
196:
190:
184:
181:
176:
174:Hypertrichosis
171:
165:
157:
154:
141:
138:
109:
106:
49:
48:
44:
43:
35:
34:
31:
27:
26:
18:
15:
13:
10:
9:
6:
4:
3:
2:
1747:
1736:
1733:
1731:
1728:
1726:
1723:
1722:
1720:
1697:
1694:
1693:
1691:
1687:
1681:
1678:
1676:
1673:
1672:
1670:
1667:
1663:
1657:
1654:
1652:
1649:
1648:
1646:
1643:
1639:
1636:
1634:
1630:
1624:
1623:Sacralization
1621:
1619:
1616:
1614:
1611:
1609:
1606:
1602:
1599:
1598:
1597:
1594:
1593:
1591:
1589:
1585:
1575:
1572:
1570:
1569:Plagiocephaly
1567:
1565:
1562:
1560:
1557:
1555:
1552:
1550:
1547:
1545:
1542:
1541:
1539:
1535:
1529:
1526:
1524:
1521:
1519:
1516:
1514:
1513:Hypertelorism
1511:
1509:
1506:
1505:
1503:
1501:
1497:
1491:
1488:
1486:
1483:
1481:
1480:Scaphocephaly
1478:
1477:
1475:
1473:
1469:
1466:
1464:
1460:
1457:
1455:
1451:
1437:
1434:
1432:
1429:
1427:
1424:
1423:
1421:
1417:
1409:
1406:
1404:
1401:
1399:
1396:
1395:
1394:
1393:
1389:
1387:
1384:
1383:
1381:
1377:
1369:
1366:
1365:
1364:
1363:Brachydactyly
1361:
1359:
1356:
1354:
1351:
1349:
1346:
1342:
1339:
1338:
1337:
1333:
1330:
1329:
1327:
1325:
1321:
1318:
1316:Either / both
1314:
1304:
1301:
1299:
1296:
1294:
1291:
1287:
1284:
1283:
1282:
1281:
1277:
1273:
1270:
1268:
1265:
1264:
1263:
1262:
1258:
1257:
1255:
1253:
1249:
1243:
1240:
1238:
1235:
1233:
1230:
1228:
1225:
1223:
1220:
1218:
1215:
1214:
1212:
1210:
1206:
1200:
1197:
1195:
1192:
1190:
1187:
1185:
1184:Hip dysplasia
1181:
1178:
1177:
1175:
1173:
1169:
1166:
1164:
1160:
1150:
1147:
1145:
1142:
1140:
1137:
1135:
1132:
1131:
1129:
1127:
1123:
1117:
1114:
1112:
1109:
1107:
1104:
1103:
1101:
1099:
1095:
1091:
1088:
1086:
1082:
1079:
1077:
1073:
1069:
1065:
1061:
1057:
1053:
1046:
1041:
1039:
1034:
1032:
1027:
1026:
1023:
1007:
1006:Syringomyelia
1004:
1002:
999:
997:
994:
993:
991:
987:
981:
978:
976:
973:
972:
970:
968:
964:
961:
959:
955:
943:
940:
939:
938:
935:
934:
929:
926:
924:
921:
920:
919:
918:
914:
913:
910:
907:
905:
902:
900:
897:
895:
892:
891:
886:
883:
881:
878:
876:
873:
871:
870:Lissencephaly
868:
866:
863:
862:
861:
858:
857:
852:
849:
848:
847:
844:
842:
839:
838:
836:
832:
826:
823:
821:
820:Encephalocele
818:
814:
811:
809:
806:
804:
801:
798:
797:
796:
793:
792:
790:
788:
784:
781:
779:
775:
771:
767:
760:
755:
753:
748:
746:
741:
740:
737:
726:
722:
717:
712:
707:
702:
698:
694:
690:
683:
680:
675:
671:
667:
663:
659:
652:
650:
648:
646:
644:
642:
640:
638:
636:
634:
630:
625:
621:
616:
611:
607:
603:
599:
592:
590:
588:
586:
584:
582:
580:
578:
576:
574:
572:
570:
568:
566:
564:
562:
560:
558:
556:
554:
552:
550:
548:
546:
542:
537:
533:
529:
525:
521:
517:
510:
508:
506:
504:
502:
500:
498:
496:
494:
492:
490:
488:
486:
484:
482:
480:
478:
476:
474:
472:
470:
468:
466:
464:
462:
460:
456:
451:
447:
444:(3): 188â91.
443:
439:
432:
425:
423:
421:
419:
417:
415:
413:
411:
409:
407:
405:
403:
401:
399:
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391:
386:
382:
377:
372:
367:
362:
358:
354:
350:
343:
340:
333:
331:
329:
324:
320:
319:gluteal cleft
311:
309:
305:
302:
298:
290:
288:
286:
282:
281:calcification
278:
274:
267:
265:
263:
259:
255:
251:
247:
243:
239:
235:
227:
225:
223:
219:
215:
211:
207:
199:
195:
191:
189:
186:Subcutaneous
185:
182:
180:
177:
175:
172:
170:
166:
163:
162:
161:
155:
153:
151:
147:
139:
137:
135:
131:
127:
123:
119:
118:neuroectoderm
115:
108:Embryogenesis
107:
105:
103:
99:
93:
92:region down.
91:
87:
83:
79:
75:
71:
70:neuroectoderm
67:
63:
59:
55:
45:
41:
36:
32:
28:
23:
1544:Macrocephaly
1390:
1386:Acheiropodia
1358:Ectrodactyly
1278:
1259:
1144:Oligodactyly
1139:Clinodactyly
1068:Appendicular
980:Rachischisis
975:Spina bifida
923:Porencephaly
915:
859:
841:Microcephaly
813:Iniencephaly
699:(15): 4549.
696:
692:
682:
668:(3): 243â6.
665:
661:
605:
601:
519:
515:
441:
437:
359:(15): 4549.
356:
352:
342:
315:
306:
301:Prophylactic
294:
271:
246:dermoid cyst
234:spinal fluid
231:
203:
159:
143:
111:
98:neuroimaging
94:
53:
52:
1574:Saddle nose
1341:Webbed toes
1332:Polydactyly
1217:Genu valgum
1149:Polydactyly
958:Spinal cord
795:Anencephaly
242:spinal cord
214:spinal cord
134:deep fascia
82:lumbosacral
30:Other names
1719:Categories
1549:Platybasia
1485:Oxycephaly
1398:Phocomelia
1392:Ectromelia
1368:Stub thumb
1336:Syndactyly
1303:Hammer toe
1272:Pigeon toe
1222:Genu varum
1194:Coxa valga
1052:Congenital
880:Pachygyria
766:Congenital
516:Pediatrics
334:References
222:meningitis
210:dura mater
169:hemangioma
1601:Scoliosis
1408:Hemimelia
1293:Pes cavus
1286:Flat feet
1267:Club foot
1199:Coxa vara
808:Acalvaria
608:(1): e4.
297:resection
291:Treatment
262:sphincter
250:epidermis
200:Infection
194:infection
140:Diagnosis
74:gestation
1651:Cervical
1098:shoulder
1094:clavicle
1076:dysmelia
917:CNS cyst
799:Acephaly
725:35956164
674:11593240
624:16749756
536:12949296
450:22009122
385:35956164
323:caudally
285:sonogram
179:Skin tag
150:children
122:mesoderm
114:ectoderm
66:ectoderm
62:neuraxis
1666:sternum
803:Acrania
716:9369492
376:9369492
328:neonate
312:History
268:Imaging
218:abscess
208:of the
146:infants
102:lesions
90:occiput
1689:other:
1403:Amelia
1280:valgus
723:
713:
672:
622:
534:
448:
383:
373:
254:dermis
206:fascia
188:lipoma
86:nasion
78:lumbar
1656:Bifid
1537:other
1454:Axial
1261:varus
989:Other
834:Other
778:Brain
434:(PDF)
277:X-ray
238:cysts
1642:ribs
1209:knee
1085:Arms
1072:limb
721:PMID
670:PMID
620:PMID
532:PMID
446:PMID
381:PMID
258:gait
252:and
240:and
148:and
88:and
80:and
68:and
1172:hip
1163:Leg
711:PMC
701:doi
610:doi
524:doi
520:112
371:PMC
361:doi
1721::
1334:/
1182:/
1096:/
1074:/
1058:/
719:.
709:.
697:11
695:.
691:.
666:49
664:.
660:.
632:^
618:.
606:10
604:.
600:.
544:^
530:.
518:.
458:^
442:20
440:.
436:.
393:^
379:.
369:.
357:11
355:.
351:.
104:.
1668::
1644::
1044:e
1037:t
1030:v
758:e
751:t
744:v
727:.
703::
676:.
626:.
612::
538:.
526::
452:.
387:.
363::
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