Congenital dermal sinus tract (CDST) is a rare entity of spinal dysraphism with an incidence of 1 in 2500 live births. The presumed etiology relates to a focal failure of disjunction resulting in a persistent adhesion...Congenital dermal sinus tract (CDST) is a rare entity of spinal dysraphism with an incidence of 1 in 2500 live births. The presumed etiology relates to a focal failure of disjunction resulting in a persistent adhesion between the neural and cutaneous ectoderm. CDST is commonly associated with other pathologies such as myelomeningocele, split cord malformation, tethered cord and inclusion tumors. The authors report a case of a 2-year-old girl discharging lumbosacral CDST. The preoperative MRI showed the dermal sinus tract with 2 intradural lesions from L1 to L3. The tract was surgically excised followed by complete excision of the cyst and lipoma. The dermal sinus tract was attached to the medullary cone and was cut there, allowing “en bloc” removal of the dermal sinus tract. There were two distinct types of tumor. One cystic is located posterior to the medullary cone and the other is located laterally to the medullary cone, whose appearance suggests a lipoma. Both tumors were removed completely. The dura was closed in a tight manner. The pathological examination confirmed the lipoma and Dermoid Cyst. In the postoperative course, the child had a motor deficit in the lower limbs, which recovered completely after 3 months of physiotherapy.展开更多
Cervical meningoceles are the least common forms of spina bifida, representing between 4% to 8% of all spinal dysraphisms. They are not accompanied by neurological deficit in childhood but attached cord syndrome can o...Cervical meningoceles are the least common forms of spina bifida, representing between 4% to 8% of all spinal dysraphisms. They are not accompanied by neurological deficit in childhood but attached cord syndrome can occur with growth. Surgical treatment, in addition to avoiding rupture and correcting the aesthetic damage, will preserve neurological functions. We report 2 cases that we took care of. They are a 5-month-old infant and a 3-year-old girl. The first presented a 7 cm rounded meningocele pedunculated through the C1 lamina defect. The second presented an 8.6 cm polylobed meningocele pedunculated through the C2 lamina defect. They both underwent surgery with good progress.展开更多
Objective To investigate the corrective results of congenital scoliosis with type II split spinal cord malformation.Methods By reviewing the medical records and roentgenograms of congenital scoliosis patients with typ...Objective To investigate the corrective results of congenital scoliosis with type II split spinal cord malformation.Methods By reviewing the medical records and roentgenograms of congenital scoliosis patients with type II split spinal cord malformation that underwent corrective surgery, septum location and length, curve type, coronal and sagittal Cobb’s angles, apical vertebral rotation and translation, and trunk shift were measured and analyzed.Results A total of 23 congenital scoliosis patients with type II split spinal cord malformation were studied, 6 cases were due to failure of segmentation, 8 cases due to failure of formation, and the remaining 9 cases due to mixed defects.The fibrous septums were located in the thoracic spine in 8 patients, lumbar spine in 4 patients, thoracic and lumbar spine in 10 patients, and from cervical to lumbar spine in 1 patient.The septum extended an average of 4.9 segments.Corrective surgeries included anterior correction with instrumentation in 2 patients, posterior correction with instrumentation in 11 patients, anterior release and posterior correction with instrumentation in 6 patients, anterior and posterior resection of the hemivertebra and posterior correction with instrumentation in 4 patients.The pre- and postoperative coronal Cobb’s angles, apical vertebral translations, apical vertebral rotations, trunk shifts were 61.9° and 32.5°(P<0.001), 48.9 mm and 31.5 mm (P<0.001), 1.2 and 1.1, 12.7 mm and 8.2 mm, respectively.The average correction rate of coronal Cobbs angle was 47.5%.The sagittal balance was also well improved.The fibrous septums were all left in situ. There was no neurological complication.Conclusion For congenital scoliosis with type II split spinal cord malformation, positive correction results with no neurological complication may be obtained without resection of the fibrous septum.展开更多
Sacral dimples are the most common cutaneous anomaly detected during neonatal spinal examination. Congenital dermal sinus tract, a rare type of spinal dysraphism, occurs along the midline neuraxis from occiput down to...Sacral dimples are the most common cutaneous anomaly detected during neonatal spinal examination. Congenital dermal sinus tract, a rare type of spinal dysraphism, occurs along the midline neuraxis from occiput down to the sacral region. It is often diagnosed in the presence of a sacral dimple together with skin signs, local infection, meningitis, abscess, or abnormal neurological examination. We report a case of acute flaccid paralysis with sensory level in a 4 mo old female infant with sacral dimple, diagnosed by magnetic resonance imaging to be a paraspinal subdural abscess. Surgical exploration revealed a congenital dermal sinus tract extending from the subdural abscess down to the sacral dimple and open to the exterior with a minute opening.展开更多
Congenital dermal sinuses are a rare entity of spinal dysraphism. Most patients have cutaneous markers of their presence, including nevus or port wine stains, dimple, hypertrichosis and subcutaneous lipoma. Inclusion ...Congenital dermal sinuses are a rare entity of spinal dysraphism. Most patients have cutaneous markers of their presence, including nevus or port wine stains, dimple, hypertrichosis and subcutaneous lipoma. Inclusion tumors, such as dermoid tumor, are associated to dermal sinus tract;they are congenital, benign and slow-growing lesions of midline. Their clinical relevance is due to the possibility of causing infection, spinal abscess, signs of corde or nerve root compression. Spinal Magnetic Resonance Imaging (MRI) is the diagnostic tool of choice. We present the case of a child with atypical meningitis, resistant to large spectrum antibiotic therapy, caused by an infected dermoid cyst, undiagnosed in the first months of life despite repeated MRI.展开更多
文摘Congenital dermal sinus tract (CDST) is a rare entity of spinal dysraphism with an incidence of 1 in 2500 live births. The presumed etiology relates to a focal failure of disjunction resulting in a persistent adhesion between the neural and cutaneous ectoderm. CDST is commonly associated with other pathologies such as myelomeningocele, split cord malformation, tethered cord and inclusion tumors. The authors report a case of a 2-year-old girl discharging lumbosacral CDST. The preoperative MRI showed the dermal sinus tract with 2 intradural lesions from L1 to L3. The tract was surgically excised followed by complete excision of the cyst and lipoma. The dermal sinus tract was attached to the medullary cone and was cut there, allowing “en bloc” removal of the dermal sinus tract. There were two distinct types of tumor. One cystic is located posterior to the medullary cone and the other is located laterally to the medullary cone, whose appearance suggests a lipoma. Both tumors were removed completely. The dura was closed in a tight manner. The pathological examination confirmed the lipoma and Dermoid Cyst. In the postoperative course, the child had a motor deficit in the lower limbs, which recovered completely after 3 months of physiotherapy.
文摘Cervical meningoceles are the least common forms of spina bifida, representing between 4% to 8% of all spinal dysraphisms. They are not accompanied by neurological deficit in childhood but attached cord syndrome can occur with growth. Surgical treatment, in addition to avoiding rupture and correcting the aesthetic damage, will preserve neurological functions. We report 2 cases that we took care of. They are a 5-month-old infant and a 3-year-old girl. The first presented a 7 cm rounded meningocele pedunculated through the C1 lamina defect. The second presented an 8.6 cm polylobed meningocele pedunculated through the C2 lamina defect. They both underwent surgery with good progress.
文摘Objective To investigate the corrective results of congenital scoliosis with type II split spinal cord malformation.Methods By reviewing the medical records and roentgenograms of congenital scoliosis patients with type II split spinal cord malformation that underwent corrective surgery, septum location and length, curve type, coronal and sagittal Cobb’s angles, apical vertebral rotation and translation, and trunk shift were measured and analyzed.Results A total of 23 congenital scoliosis patients with type II split spinal cord malformation were studied, 6 cases were due to failure of segmentation, 8 cases due to failure of formation, and the remaining 9 cases due to mixed defects.The fibrous septums were located in the thoracic spine in 8 patients, lumbar spine in 4 patients, thoracic and lumbar spine in 10 patients, and from cervical to lumbar spine in 1 patient.The septum extended an average of 4.9 segments.Corrective surgeries included anterior correction with instrumentation in 2 patients, posterior correction with instrumentation in 11 patients, anterior release and posterior correction with instrumentation in 6 patients, anterior and posterior resection of the hemivertebra and posterior correction with instrumentation in 4 patients.The pre- and postoperative coronal Cobb’s angles, apical vertebral translations, apical vertebral rotations, trunk shifts were 61.9° and 32.5°(P<0.001), 48.9 mm and 31.5 mm (P<0.001), 1.2 and 1.1, 12.7 mm and 8.2 mm, respectively.The average correction rate of coronal Cobbs angle was 47.5%.The sagittal balance was also well improved.The fibrous septums were all left in situ. There was no neurological complication.Conclusion For congenital scoliosis with type II split spinal cord malformation, positive correction results with no neurological complication may be obtained without resection of the fibrous septum.
文摘Sacral dimples are the most common cutaneous anomaly detected during neonatal spinal examination. Congenital dermal sinus tract, a rare type of spinal dysraphism, occurs along the midline neuraxis from occiput down to the sacral region. It is often diagnosed in the presence of a sacral dimple together with skin signs, local infection, meningitis, abscess, or abnormal neurological examination. We report a case of acute flaccid paralysis with sensory level in a 4 mo old female infant with sacral dimple, diagnosed by magnetic resonance imaging to be a paraspinal subdural abscess. Surgical exploration revealed a congenital dermal sinus tract extending from the subdural abscess down to the sacral dimple and open to the exterior with a minute opening.
文摘Congenital dermal sinuses are a rare entity of spinal dysraphism. Most patients have cutaneous markers of their presence, including nevus or port wine stains, dimple, hypertrichosis and subcutaneous lipoma. Inclusion tumors, such as dermoid tumor, are associated to dermal sinus tract;they are congenital, benign and slow-growing lesions of midline. Their clinical relevance is due to the possibility of causing infection, spinal abscess, signs of corde or nerve root compression. Spinal Magnetic Resonance Imaging (MRI) is the diagnostic tool of choice. We present the case of a child with atypical meningitis, resistant to large spectrum antibiotic therapy, caused by an infected dermoid cyst, undiagnosed in the first months of life despite repeated MRI.
