{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T10:17:35Z","timestamp":1777889855653,"version":"3.51.4"},"reference-count":45,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Dermal sinus tracts (DSTs) are rare congenital lesions resulting from errors of spinal cord disjunction, leading to a persistent connection between the cutaneous ectoderm and underlying neural elements. As patients are at increased risk of infection and irreversible neurological compromise due to tethering, resection and detethering are recommended as a prophylactic measure. The ideal timing of surgical intervention in an asymptomatic cohort, however, remains unclear.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>A retrospective chart review was performed at a single institution from 1998 to 2022 of all patients surgically treated for lumbar DST by 10 different surgeons. Demographic, presentation, operative, and postoperative details were obtained. Five patients who presented with infectious or neurological symptoms were excluded from primary analysis. The age at the time of surgery was then analyzed as a continuous variable against the operative details and postoperative outcomes utilizing Spearman\u2019s correlation coefficient and the Mann-Whitney U-test.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Fifty-two patients underwent prophylactic surgical excision of their DST as well as detethering. Overall, 65% of patients were female and the median age at diagnosis was 3 months, while the median age at the time of surgery was 7 months. An additional cutaneous finding was identified in 71% of patients, with hemangioma being most frequent (40%). Additional spinal lesions were radiographically identified in 29% of patients, including lipoma (19%), dermoid and epidermoid inclusion cysts (8%), and an arachnoid cyst (2%). Postoperative complications occurred in 8% (n = 4) of patients, primarily related to wound healing (3\/4), with significant risk attributed to younger age at time of surgery (mean 3 months, range 1\u20135 months) (p = 0.01). During 56 months of follow-up, long-term rates of retethering (6%, p = 0.02) and abnormal neurological examinations (8%, p = 0.001) were associated with concurrent lipomas, but not with age at operation.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>In a series of 52 pediatric patients undergoing prophylactic resection of a DST with detethering, the complication rate was 8% and was significantly associated with age &lt; 6 months at the time of operation. Associated spinal lipomas significantly influenced long-term outcomes. When evaluating asymptomatic infants with DST, patient age is a significant factor in assessing the risks and benefits of surgical timing.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.9.peds24149","type":"journal-article","created":{"date-parts":[[2024,11,30]],"date-time":"2024-11-30T02:41:38Z","timestamp":1732934498000},"page":"1-9","source":"Crossref","is-referenced-by-count":2,"title":["The importance of timing: evaluating the optimal age for surgical intervention in asymptomatic dermal sinus tracts"],"prefix":"10.3171","author":[{"given":"Kelsi M.","family":"Chesney","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Children\u2019s National Medical Center;"},{"name":"Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, DC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory F.","family":"Keating","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Children\u2019s National Medical Center;"},{"name":"Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, DC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nirali","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Children\u2019s National Medical Center;"},{"name":"Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, DC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Aguilera","sequence":"additional","affiliation":[{"name":"Georgetown School of Medicine; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John S.","family":"Myseros","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Children\u2019s National Medical Center;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chima","family":"Oluigbo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Children\u2019s National Medical Center;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hasan R.","family":"Syed","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Children\u2019s National Medical Center;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert F.","family":"Keating","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Children\u2019s National Medical Center;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"1","key":"b1","series-title":"Dev Disabil Res Rev","first-page":"6","article-title":"Epidemiologic and genetic aspects of spina bifida and other neural tube defects","volume":"16","author":"Au KS","year":"2010","unstructured":"Au KS, Ashley-Koch A, Northrup H. Epidemiologic and genetic aspects of spina bifida and other neural tube defects. Dev Disabil Res Rev. 2010;16(1):6\u201315."},{"issue":"2","key":"b2","series-title":"Wiley Interdiscip Rev Dev Biol","first-page":"213","article-title":"Neural tube defects\u2014disorders of neurulation and related embryonic processes","volume":"2","author":"Copp AJ","year":"2013","unstructured":"Copp AJ, Greene ND. Neural tube defects\u2014disorders of neurulation and related embryonic processes. Wiley Interdiscip Rev Dev Biol. 2013;2(2):213\u2013227."},{"key":"b3","series-title":"Disorders of the Pediatric Spine","first-page":"349","article-title":"Congenital dermal sinus","author":"McComb J","year":"1995","unstructured":"McComb J. Congenital dermal sinus. In: Pang D, ed.Disorders of the Pediatric Spine. Raven Press;1995:349-360."},{"issue":"2","key":"b4","series-title":"Pediatr Neurosurg","first-page":"86","article-title":"Cranial dermal sinus: presentation, complications and management","volume":"48","author":"Naderi S","year":"2012","unstructured":"Naderi S, Nejat F, Shahjouei S, El Khashab M. Cranial dermal sinus: presentation, complications and management. Pediatr Neurosurg. 2012;48(2):86\u201392."},{"key":"b5","series-title":"Clin Neurosurg","first-page":"295","article-title":"The embryology of spinal dysraphism","volume":"30","author":"French BN","year":"1983","unstructured":"French BN. The embryology of spinal dysraphism. Clin Neurosurg. 1983;30:295\u2013340."},{"issue":"2","key":"b6","series-title":"J Pathol","first-page":"217","article-title":"Genetics and development of neural tube defects","volume":"220","author":"Copp AJ","year":"2010","unstructured":"Copp AJ, Greene ND. Genetics and development of neural tube defects. J Pathol. 2010;220(2):217\u2013230."},{"issue":"8","key":"b7","series-title":"Birth Defects Res A Clin Mol Teratol","first-page":"653","article-title":"An update to the list of mouse mutants with neural tube closure defects and advances toward a complete genetic perspective of neural tube closure","volume":"88","author":"Harris MJ","year":"2010","unstructured":"Harris MJ, Juriloff DM. An update to the list of mouse mutants with neural tube closure defects and advances toward a complete genetic perspective of neural tube closure. Birth Defects Res A Clin Mol Teratol. 2010;88(8):653\u2013669."},{"issue":"2","key":"b8","series-title":"Dev Dyn","first-page":"117","article-title":"Towards a cellular and molecular understanding of neurulation","volume":"221","author":"Colas JF","year":"2001","unstructured":"Colas JF, Schoenwolf GC. Towards a cellular and molecular understanding of neurulation. Dev Dyn. 2001;221(2):117\u2013145."},{"issue":"2","key":"b9","series-title":"J Korean Neurosurg Soc","first-page":"151","article-title":"Focal spinal nondisjunction in primary neurulation: limited dorsal myeloschisis and congenital spinal dermal sinus tract","volume":"64","author":"Wong ST","year":"2021","unstructured":"Wong ST, Pang D. Focal spinal nondisjunction in primary neurulation: limited dorsal myeloschisis and congenital spinal dermal sinus tract. J Korean Neurosurg Soc. 2021;64(2):151\u2013188."},{"issue":"6","key":"b10","series-title":"Eur J Paediatr Neurol","first-page":"575","article-title":"Spinal dermal sinuses and dermal sinus-like stalks analysis of 14 cases with suggestions for embryologic mechanisms resulting in dermal sinus-like stalks","volume":"17","author":"De Vloo P","year":"2013","unstructured":"De Vloo P, Lagae L, Sciot R, Demaerel P, van Loon J, Van Calenbergh F. Spinal dermal sinuses and dermal sinus-like stalks analysis of 14 cases with suggestions for embryologic mechanisms resulting in dermal sinus-like stalks. Eur J Paediatr Neurol. 2013;17(6):575\u2013584."},{"issue":"3","key":"b11","series-title":"Childs Nerv Syst","first-page":"349","article-title":"Dermal sinus tract of the spine","volume":"26","author":"Radmanesh F","year":"2010","unstructured":"Radmanesh F, Nejat F, El Khashab M. Dermal sinus tract of the spine. Childs Nerv Syst. 2010;26(3):349\u2013357."},{"issue":"Suppl 17","key":"b12","series-title":"Surg Neurol Int","first-page":"S429","article-title":"Spinal dorsal dermal sinus tract: an experience of 21 cases","volume":"6","author":"Singh I","year":"2015","unstructured":"Singh I, Rohilla S, Kumar P, Sharma S. Spinal dorsal dermal sinus tract: an experience of 21 cases. Surg Neurol Int. 2015;6(Suppl 17):S429\u2013S434."},{"issue":"6","key":"b13","series-title":"J Neurosurg Pediatr","first-page":"651","article-title":"Congenital spinal dermal tract: how accurate is clinical and radiological evaluation","volume":"15","author":"Tisdall MM","year":"2015","unstructured":"Tisdall MM, Hayward RD, Thompson DN. Congenital spinal dermal tract: how accurate is clinical and radiological evaluation? J Neurosurg Pediatr. 2015;15(6):651\u2013656."},{"issue":"2","key":"b14","series-title":"Pediatr Neurol","first-page":"144","article-title":"Spinal intramedullary abscess with an epidermoid secondary to a dermal sinus","volume":"37","author":"Hung PC","year":"2007","unstructured":"Hung PC, Wang HS, Wu CT, Lui TN, Wong AM. Spinal intramedullary abscess with an epidermoid secondary to a dermal sinus. Pediatr Neurol. 2007;37(2):144\u2013147."},{"issue":"3 Pt 1","key":"b15","series-title":"Pediatrics","first-page":"641","article-title":"Spinal congenital dermal sinuses: a 30-year experience","volume":"112","author":"Ackerman LL","year":"2003","unstructured":"Ackerman LL, Menezes AH. Spinal congenital dermal sinuses: a 30-year experience. Pediatrics. 2003;112(3 Pt 1):641\u2013647."},{"issue":"8","key":"b16","series-title":"Childs Nerv Syst","first-page":"1807","article-title":"Radiologically occult cervical intradural dermal sinus tract: a case report and review of literature","volume":"36","author":"Mukai T","year":"2020","unstructured":"Mukai T, Usami K, Ishisaka E, Ogiwara H. Radiologically occult cervical intradural dermal sinus tract: a case report and review of literature. Childs Nerv Syst. 2020;36(8):1807\u20131809."},{"issue":"3","key":"b17","series-title":"Neurol India","first-page":"243","article-title":"Spinal congenital dermal sinus: an experience of 23 cases over 7 years","volume":"49","author":"Jindal A","year":"2001","unstructured":"Jindal A, Mahapatra AK. Spinal congenital dermal sinus: an experience of 23 cases over 7 years. Neurol India. 2001;49(3):243\u2013246."},{"issue":"1","key":"b18","series-title":"Neurosurg Focus","first-page":"E4","article-title":"Dermal sinus tracts of the spine","volume":"10","author":"Elton S","year":"2001","unstructured":"Elton S, Oakes WJ. Dermal sinus tracts of the spine. Neurosurg Focus. 2001;10(1):E4."},{"issue":"4","key":"b19","series-title":"Childs Nerv Syst","first-page":"609","article-title":"Spinal dermal sinus and pseudo-dermal sinus tracts: two different entities","volume":"27","author":"Mart\u00ednez-Lage JF","year":"2011","unstructured":"Mart\u00ednez-Lage JF, Almagro MJ, Ferri-\u00d1iguez B, Izura Azanza V, Serrano C, Domenech E. Spinal dermal sinus and pseudo-dermal sinus tracts: two different entities. Childs Nerv Syst. 2011;27(4):609\u2013616."},{"issue":"10","key":"b20","series-title":"J Child Neurol","first-page":"1277","article-title":"Congenital dermal sinus tract of the spine: experience of 16 patients","volume":"29","author":"Mete M","year":"2014","unstructured":"Mete M, Umur AS, Duransoy YK,  Congenital dermal sinus tract of the spine: experience of 16 patients. J Child Neurol. 2014;29(10):1277\u20131282."},{"issue":"10","key":"b21","series-title":"Childs Nerv Syst","first-page":"1220","article-title":"Congenital spinal dermal sinuses: poor awareness leads to delayed treatment","volume":"22","author":"Ramnarayan R","year":"2006","unstructured":"Ramnarayan R, Dominic A, Alapatt J, Buxton N. Congenital spinal dermal sinuses: poor awareness leads to delayed treatment. Childs Nerv Syst. 2006;22(10):1220\u20131224."},{"issue":"4","key":"b22","series-title":"Iran J Child Neurol","first-page":"101","article-title":"Congenital spinal dysraphism with infected sacrococcygeal sinus tract: need for improved awareness amongst clinicians","volume":"14","author":"Ahmed S","year":"2020","unstructured":"Ahmed S, Dutta D, Paul SP. Congenital spinal dysraphism with infected sacrococcygeal sinus tract: need for improved awareness amongst clinicians. Iran J Child Neurol. 2020;14(4):101\u2013105."},{"issue":"5","key":"b23","series-title":"Pediatrics","first-page":"E69","article-title":"Coccygeal pits","volume":"105","author":"Weprin BE","year":"2000","unstructured":"Weprin BE, Oakes WJ. Coccygeal pits. Pediatrics. 2000;105(5):E69."},{"issue":"4","key":"b24","series-title":"Pediatrics","first-page":"e1105","article-title":"Congenital brain and spinal cord malformations and their associated cutaneous markers","volume":"136","author":"Dias M","year":"2015","unstructured":"Dias M, Partington M. Congenital brain and spinal cord malformations and their associated cutaneous markers. Pediatrics. 2015;136(4):e1105\u2013e1119."},{"issue":"5","key":"b25","series-title":"J Neurosurg Pediatr","first-page":"607","article-title":"Perioperative complications and secondary retethering after pediatric tethered cord release surgery","volume":"32","author":"Pan J","year":"2023","unstructured":"Pan J, Boop SH, Barber JK,  Perioperative complications and secondary retethering after pediatric tethered cord release surgery. J Neurosurg Pediatr. 2023;32(5):607\u2013616."},{"issue":"4","key":"b26","series-title":"Childs Nerv Syst","first-page":"1005","article-title":"Electrodiagnosis has a potential to identify neural damage in asymptomatic infants with closed spinal dysraphism","volume":"39","author":"Park M","year":"2023","unstructured":"Park M, Kim A, Wang KC,  Electrodiagnosis has a potential to identify neural damage in asymptomatic infants with closed spinal dysraphism. Childs Nerv Syst. 2023;39(4):1005\u20131012."},{"issue":"3","key":"b27","series-title":"Eur J Pediatr Surg","first-page":"229","article-title":"Spinal intramedullary abscess secondary to dermal sinus in children","volume":"29","author":"Prasad GL","year":"2019","unstructured":"Prasad GL, Hegde A, Divya S. Spinal intramedullary abscess secondary to dermal sinus in children. Eur J Pediatr Surg. 2019;29(3):229\u2013238."},{"issue":"7","key":"b28","series-title":"Paediatr Anaesth","first-page":"801","article-title":"Perioperative critical events and morbidity associated with anesthesia in early life: subgroup analysis of United Kingdom participation in the NEonate and Children audiT of Anaesthesia pRactice IN Europe (NECTARINE) prospective multicenter observational study","volume":"32","author":"Walker SM","year":"2022","unstructured":"Walker SM, Engelhardt T, Ahmad N, Dobby N. Perioperative critical events and morbidity associated with anesthesia in early life: subgroup analysis of United Kingdom participation in the NEonate and Children audiT of Anaesthesia pRactice IN Europe (NECTARINE) prospective multicenter observational study. Paediatr Anaesth. 2022;32(7):801\u2013814."},{"issue":"5","key":"b29","series-title":"Lancet Respir Med","first-page":"412","article-title":"Incidence of severe critical events in paediatric anaesthesia (APRICOT): a prospective multicentre observational study in 261 hospitals in Europe","volume":"5","author":"Habre W","year":"2017","unstructured":"Habre W, Disma N, Virag K,  Incidence of severe critical events in paediatric anaesthesia (APRICOT): a prospective multicentre observational study in 261 hospitals in Europe. Lancet Respir Med. 2017;5(5):412\u2013425."},{"issue":"5","key":"b30","series-title":"Eur J Pediatr Surg","first-page":"275","article-title":"Metabolic response to surgery in infants and children","volume":"19","author":"McHoney M","year":"2009","unstructured":"McHoney M, Eaton S, Pierro A. Metabolic response to surgery in infants and children. Eur J Pediatr Surg. 2009;19(5):275\u2013285."},{"issue":"3","key":"b31","series-title":"Pediatr Radiol","first-page":"315","article-title":"Spinal dysraphism associated with the cutaneous lumbosacral infantile hemangioma: a neuroradiological review","volume":"42","author":"Schumacher WE","year":"2012","unstructured":"Schumacher WE, Drolet BA, Maheshwari M,  Spinal dysraphism associated with the cutaneous lumbosacral infantile hemangioma: a neuroradiological review. Pediatr Radiol. 2012;42(3):315\u2013320."},{"issue":"6","key":"b32","series-title":"Int J Dermatol","first-page":"737","article-title":"The prevalence, complications, and risk factors for infantile hemangioma: a systematic review and meta-analysis","volume":"63","author":"Sun Y","year":"2024","unstructured":"Sun Y, Zhao J, Meng Y,  The prevalence, complications, and risk factors for infantile hemangioma: a systematic review and meta-analysis. Int J Dermatol. 2024;63(6):737\u2013746."},{"issue":"2","key":"b33","series-title":"J Am Acad Dermatol","first-page":"414","article-title":"Incidence and clinical factors associated with ulceration in infantile hemangiomas","volume":"88","author":"Fern\u00e1ndez Faith E","year":"2023","unstructured":"Fern\u00e1ndez Faith E, Shah SD, Braun M,  Incidence and clinical factors associated with ulceration in infantile hemangiomas. J Am Acad Dermatol. 2023;88(2):414\u2013420."},{"issue":"4","key":"b34","series-title":"J Am Acad Dermatol","first-page":"477","article-title":"Hemangiomas of infancy","volume":"48","author":"Bruckner AL","year":"2003","unstructured":"Bruckner AL, Frieden IJ. Hemangiomas of infancy. J Am Acad Dermatol. 2003;48(4):477\u2013496."},{"issue":"5","key":"b35","series-title":"Pediatr Neurosurg","first-page":"416","article-title":"Surgical treatment of congenital dermal sinus: an experience of 56 cases","volume":"56","author":"Song Y","year":"2021","unstructured":"Song Y, Xia Z, Qiu S, Gao P, Yang B, Bao N. Surgical treatment of congenital dermal sinus: an experience of 56 cases. Pediatr Neurosurg. 2021;56(5):416\u2013423."},{"issue":"1","key":"b36","series-title":"J Neurosurg Pediatr","first-page":"86","article-title":"Rapid-onset paraparesis and quadriparesis in patients with intramedullary spinal dermoid cysts: report of 10 cases","volume":"17","author":"Girishan S","year":"2016","unstructured":"Girishan S, Rajshekhar V. Rapid-onset paraparesis and quadriparesis in patients with intramedullary spinal dermoid cysts: report of 10 cases. J Neurosurg Pediatr. 2016;17(1):86\u201393."},{"key":"b37","series-title":"World Neurosurg","first-page":"e438","article-title":"Clinical presentation and surgical outcomes based on age and tumor topography in 59 patients with spinal dermoid cysts","volume":"151","author":"Sarkar S","year":"2021","unstructured":"Sarkar S, Rajshekhar V. Clinical presentation and surgical outcomes based on age and tumor topography in 59 patients with spinal dermoid cysts. World Neurosurg. 2021;151:e438\u2013e446."},{"issue":"4","key":"b38","series-title":"Pediatr Neurosurg","first-page":"281","article-title":"Intraspinal dermoid and epidermoid tumors: report of 18 cases and reappraisal of the literature","volume":"45","author":"van Aalst J","year":"2009","unstructured":"van Aalst J, Hoekstra F, Beuls EA,  Intraspinal dermoid and epidermoid tumors: report of 18 cases and reappraisal of the literature. Pediatr Neurosurg. 2009;45(4):281\u2013290."},{"issue":"5","key":"b39","series-title":"J Neurosurg Pediatr","first-page":"537","article-title":"Surgical management of complex spinal cord lipomas: how, why, and when to operate. A review. JNSPG 75th Anniversary Invited Review Article","volume":"23","author":"Pang D","year":"2019","unstructured":"Pang D. Surgical management of complex spinal cord lipomas: how, why, and when to operate. A review. JNSPG 75th Anniversary Invited Review Article. J Neurosurg Pediatr. 2019;23(5):537\u2013556."},{"issue":"10","key":"b40","series-title":"Childs Nerv Syst","first-page":"1731","article-title":"Asymptomatic lumbosacral lipomas\u2014a natural history study","volume":"28","author":"Wykes V","year":"2012","unstructured":"Wykes V, Desai D, Thompson DN. Asymptomatic lumbosacral lipomas\u2014a natural history study. Childs Nerv Syst. 2012;28(10):1731\u20131739."},{"issue":"10","key":"b41","series-title":"Childs Nerv Syst.","first-page":"1741","article-title":"Commentary to the article: asymptomatic lumbosacral lipomas\u2014a natural history study, by Wykes V, Desai D, and Thompson DNP.","volume":"28","author":"Pang D","year":"2012","unstructured":"Pang D. Commentary to the article: asymptomatic lumbosacral lipomas\u2014a natural history study, by Wykes V, Desai D, and Thompson DNP.Childs Nerv Syst.2012;28(10):1741\u20131742."},{"issue":"2","key":"b42","series-title":"J Pediatr Neurosci","first-page":"85","article-title":"Congenital spinal lipomas: role of prophylactic surgery","volume":"7","author":"Kumar A","year":"2012","unstructured":"Kumar A, Mahapatra AK, Satyarthee GD. Congenital spinal lipomas: role of prophylactic surgery. J Pediatr Neurosci. 2012;7(2):85\u201389."},{"issue":"3","key":"b43","series-title":"J Neurosurg Pediatr","first-page":"342","article-title":"Retethering risk in pediatric spinal lipoma of the conus medullaris","volume":"29","author":"Hayashi T","year":"2021","unstructured":"Hayashi T, Kimiwada T, Shirane R, Tominaga T. Retethering risk in pediatric spinal lipoma of the conus medullaris. J Neurosurg Pediatr. 2021;29(3):342\u2013349."},{"issue":"1","key":"b44","series-title":"AJNR Am J Neuroradiol","first-page":"176","article-title":"Limited dorsal myeloschisis and congenital dermal sinus: comparison of clinical and MR imaging features","volume":"38","author":"Lee SM","year":"2017","unstructured":"Lee SM, Cheon JE, Choi YH,  Limited dorsal myeloschisis and congenital dermal sinus: comparison of clinical and MR imaging features. AJNR Am J Neuroradiol. 2017;38(1):176\u2013182."},{"issue":"1","key":"b45","series-title":"Childs Nerv Syst","first-page":"217","article-title":"Utility of CISS imaging in the management of tethered cord syndrome","volume":"37","author":"Sankhe S","year":"2021","unstructured":"Sankhe S, Dang G, Mathur S, Muzumdar D. Utility of CISS imaging in the management of tethered cord syndrome. Childs Nerv Syst. 2021;37(1):217\u2013223."}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/aop\/article-10.3171-2024.9.PEDS24149\/article-10.3171-2024.9.PEDS24149.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/aop\/article-10.3171-2024.9.PEDS24149\/article-10.3171-2024.9.PEDS24149.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/aop\/article-10.3171-2024.9.PEDS24149\/article-10.3171-2024.9.PEDS24149.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,1]],"date-time":"2025-03-01T02:47:11Z","timestamp":1740797231000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/aop\/article-10.3171-2024.9.PEDS24149\/article-10.3171-2024.9.PEDS24149.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,1]]},"references-count":45,"URL":"https:\/\/doi.org\/10.3171\/2024.9.peds24149","relation":{},"ISSN":["1933-0707","1933-0715"],"issn-type":[{"value":"1933-0707","type":"print"},{"value":"1933-0715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,1]]}}}