Sonography for detection of spinal dermal sinus tracts.
OBJECTIVE
It is well known that spinal dysraphism may be complicated by meningitis as a result of infection traveling from the skin along a patent dermal sinus tract. The only clue is the lower back cutaneous lesions. Our aim was to investigate the correlation between cutaneous lesions, patent dermal sinus tracts, and spinal dysraphism and their complications.


METHODS
Five patients (3 female and 2 male) with spinal patent dermal sinus tracts were studied. We used a 7-MHz linear transducer with a two-dimensional real-time sonographic system to insonate and obtain transverse and longitudinal views of the spinal cord and subcutaneous area, extending from the cervical cord to the sacral areas. Subsequently, we performed spinal magnetic resonance imaging in every patient to confirm the diagnosis and to evaluate the intraspinal conditions.


RESULTS
The associated central nervous system anomalies and complications were tethered cords (n = 5), dermoid cysts (n = 3), lipoma (n = 2), central nervous system infections (n = 2), and syringomyelia (n = 1). The outcomes were better in those who received surgical intervention before they were infected.


CONCLUSIONS
Early detection of spinal patent dermal sinus tracts and related anomalies was accomplished with spinal sonography and allowed for prophylactic treatment (e.g., early surgical intervention) before the onset of neurologic deficits.
Lin
Kuang-Lin
KL
Department of Pediatrics, Chang Gung Children's Hospital at Linkou, Medical College of Chang Gung University, Taoyuan, Taiwan, Republic of China.
Wang
Huei-Shyong
HS
Chou
Ming-Liang
ML
Lui
Ta-Ngar
TN
D020863:Central Nervous System Cysts / Q000000981:diagnostic imaging; D002493:Central Nervous System Diseases / Q000000981:diagnostic imaging; D003884:Dermoid Cyst / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009436:Neural Tube Defects / Q000000981:diagnostic imaging; D016136:Spina Bifida Occulta / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D014463:Ultrasonography