{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T10:31:34Z","timestamp":1781346694883,"version":"3.54.1"},"reference-count":21,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:sec>\n<jats:title>OBJECT<\/jats:title>\n<jats:p>A dermal sinus tract is a common form of occult spinal dysraphism. The presumed etiology relates to a focal failure of disjunction resulting in a persistent adhesion between the neural and cutaneous ectoderm. Clinical and radiological features can appear innocuous, leading to delayed diagnosis and failure to appreciate the implications or extent of the abnormality. If it is left untreated, complications can include meningitis, spinal abscess, and inclusion cyst formation. The authors present their experience in 74 pediatric cases of spinal dermal tract in an attempt to identify which clinical and radiological factors are associated with an infective presentation and to assess the reliability of MRI in evaluating this entity.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Consecutive cases of spinal dermal tract treated with resection between 1998 and 2010 were identified from the departmental surgical database. Demographics, clinical history, and radiological and operative findings were collected from the patient records. The presence or absence of active infection (abscess, meningitis) at the time of neurosurgical presentation and any history of local sinus discharge or infection was assessed. Magnetic resonance images were reviewed to evaluate the extent of the sinus tract and determine the presence of an inclusion cyst. Radiological and operative findings were compared.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>The surgical course was uncomplicated in 90% of 74 cases eligible for analysis. Magnetic resonance imaging underreported the presence of both an intradural tract (MRI 46%, operative finding 86%) and an intraspinal inclusion cyst (MRI 15%, operative finding 24%). A history of sinus discharge (OR 12.8, p = 0.0003) and the intraoperative identification of intraspinal inclusion cysts (OR 5.6, p = 0.023) were associated with an infective presentation. There was no significant association between the presence of an intradural tract discovered at surgery and an infective presentation.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Surgery for the treatment of spinal dermal tract carries a low morbidity. While it seems intuitive that tracts without intradural extension carry a low risk of spinal cord tethering, it is not possible to reliably detect these cases using MRI. Similarly, intraspinal dermoid cannot be reliably excluded using MRI and carries an increased risk of infection. These points justify excision together with intradural exploration of all spinal dermal sinus tracts.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2014.11.peds14341","type":"journal-article","created":{"date-parts":[[2015,3,13]],"date-time":"2015-03-13T14:02:12Z","timestamp":1426255332000},"page":"651-656","source":"Crossref","is-referenced-by-count":30,"title":["Congenital spinal dermal tract: how accurate is clinical and radiological evaluation?"],"prefix":"10.3171","volume":"15","author":[{"given":"Martin M.","family":"Tisdall","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard D.","family":"Hayward","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominic N. P.","family":"Thompson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-peds14341","series-title":"Pediatrics","doi-asserted-by":"publisher","first-page":"641","DOI":"10.1542\/peds.112.3.641","article-title":"Spinal congenital dermal sinuses: a 30-year experience","volume":"112","author":"Ackerman","year":"2003"},{"key":"b2-peds14341","series-title":"AJNR Am J Neuroradiol","first-page":"1025","article-title":"Gadopentetate dimeglumine-enhanced MR imaging of spinal dermal sinus tract","volume":"12","author":"Algra","year":"1991"},{"key":"b3-peds14341","series-title":"AJNR Am J Neuroradiol","first-page":"123","article-title":"MR evaluation of spinal dermal sinus tracts in children","volume":"12","author":"Barkovich","year":"1991"},{"issue":"1","key":"b4-peds14341","series-title":"Neurosurg Focus","first-page":"E4","article-title":"Dermal sinus tracts of the spine","volume":"10","author":"Elton","year":"2001"},{"key":"b5-peds14341","series-title":"Clin Neurosurg","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1093\/neurosurgery\/30.CN_suppl_1.295","article-title":"The embryology of spinal dysraphism","volume":"30","author":"French","year":"1983"},{"key":"b6-peds14341","series-title":"Neurological Surgery","first-page":"1081","article-title":"Midline fusion defects and defects of formation","author":"French","year":"1990"},{"key":"b7-peds14341","series-title":"Neurosurg Clin N Am","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1016\/S1042-3680(18)30468-6","article-title":"Dermoids and dermal sinus tracts of the spine","volume":"6","author":"Kanev","year":"1995"},{"key":"b8-peds14341","series-title":"Childs Brain","first-page":"1","article-title":"Meningocoele manqu\u00e9","volume":"3","author":"Lassman","year":"1977"},{"key":"b9-peds14341","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1007\/s00381-010-1308-6","article-title":"Spinal dermal sinus and pseudo-dermal sinus tracts: two different entities","volume":"27","author":"Mart\u00ednez-Lage","year":"2011"},{"key":"b10-peds14341","series-title":"Disorders of the Pediatric Spine","first-page":"349","article-title":"Congenital dermal sinus","author":"McComb","year":"1995"},{"key":"b11-peds14341","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1007\/s003810050370","article-title":"Dermal sinus and intramedullary spinal cord abscess. Report of two cases and review of the literature","volume":"15","author":"Morandi","year":"1999"},{"key":"b12-peds14341","series-title":"J Am Med Assoc","doi-asserted-by":"publisher","first-page":"1263","DOI":"10.1001\/jama.1949.02900350025007","article-title":"Congenital dermal sinuses as a cause of meningitis, intraspinal abscess and intracranial abscess","volume":"139","author":"Mount","year":"1949"},{"key":"b13-peds14341","series-title":"AJR Am J Roentgenol","doi-asserted-by":"publisher","first-page":"1065","DOI":"10.2214\/ajr.140.6.1065","article-title":"A new understanding of dorsal dysraphism with lipoma (lipomyeloschisis): radiologic evaluation and surgical correction","volume":"140","author":"Naidich","year":"1983"},{"key":"b14-peds14341","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1555","DOI":"10.1227\/NEU.0b013e3181f93e5a","article-title":"Limited dorsal myeloschisis: a distinctive clinicopathological entity","volume":"67","author":"Pang","year":"2010"},{"key":"b15-peds14341","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1007\/s00381-009-0962-z","article-title":"Dermal sinus tract of the spine","volume":"26","author":"Radmanesh","year":"2010"},{"key":"b16-peds14341","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"315","DOI":"10.3171\/SPI-07\/09\/315","article-title":"Tethering tracts in spina bifida occulta: revisiting an established nomenclature","volume":"7","author":"Rajpal","year":"2007"},{"key":"b17-peds14341","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1007\/s00381-012-1916-4","article-title":"Infections of the spinal subdural space in children: a series of 11 contemporary cases and review of all published reports. 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