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Congenital dermal sinus of the cervical spine: clinical characteristics and management
1Department of Neurosurgery, the Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an 710004, China.
Insights
Congenital dermal sinus (CDS) in the cervical spine is rare. Early surgical excision of cervical CDS in children is crucial for managing neurological deficits.
Area of Science:
- Pediatric Neurosurgery
- Spinal Cord Abnormalities
- Congenital Malformations
Background:
- Congenital dermal sinus (CDS) in the cervical region is an exceptionally rare condition.
- This case highlights the clinical presentation and management of cervical CDS in a pediatric patient.
Observation:
- A 2-year-old boy presented with a year of hand dexterity issues, diagnosed with a congenital dermal sinus in the cervical spine.
- Neurological examination revealed mild hand weakness and intrinsic muscle atrophy.
- Surgical excision and untethering were performed, with no immediate complications.
Findings:
- Histopathology confirmed a dorsal dermal sinus.
- Post-surgery, the patient maintained a stable neurological deficit over three years.
- MRI confirmed no recurrence of the sinus tract or spinal cord tethering.
Implications:
- Early surgical intervention for cervical CDS is vital to prevent or manage neurological deficits.
- This case underscores the importance of timely diagnosis and treatment in pediatric spinal abnormalities.
- Long-term follow-up is essential to monitor for any delayed neurological sequelae.
Abstract:
Congenital dermal sinus (CDS) in the cervical region is extremely rare with only few cases reported in the literature. This study reports a young case of CDS, by which we demonstrate the clinical characteristics and management of cervical CDS, particularly in kids. A 2-year and 7-month-old male child who presented with a one-year history of difficulty in holding objects by hands was diagnosed to have harbored a CDS in the cervical spine since birth. Neurological examination demonstrated mild weakness in both hands and also atrophy in intrinsic hand muscles. Surgery was performed right after diagnosis. Intraoperatively, the sinus tract was totally excised, and untethering was performed. No complications were found after operation. Histopathological examination suggested dorsal dermal sinus. During the follow-up of three years, the patient presented a stable neurologic deficit but did not suffer from an aggravation or improvement of nervous symptoms. At three-year follow-up, the patient was a stable neurologic deficit, and MRI revealed no evidence of the untethered cervical spinal cord and dermal sinus tract. The management strategies of CDS are early surgical treatment to prevent the development of neurological defects.
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