title: En bloc excision of a dermal sinus tract.
abstract: Dermal sinus tracts are a form of spinal dysraphism that arises from a failure of dysjunction early in embryogenesis. They are diagnosed in pediatric patients and who present with a dimple, infection, or neurologic deficit. The tract is surgically excised en bloc to avoid contamination from the tract, which harbors bacteria. However, dermal sinus tracts typically terminate intradurally, rendering their en bloc excision difficult. To avoid entering the tract, allowing for an en bloc excision, we modified the usual technique employed for accessing the spinal intradural space. An en bloc excision of the dermal sinus tract was successfully performed. The patient recovered from the procedure neurologically intact and her postoperative course was uncomplicated. We conclude that en bloc excision of a dermal sinus tract down to the intradural space is feasible with modifications to standard operative technique.
authors.affiliation: Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, WACC 745, 15 Parkman Street, Boston, MA 02114, USA. jcoumans@partners.org
authors.forename: Jean-Valery
authors.initials: JV
authors.lastname: Coumans
authors.forename: Brian P
authors.initials: BP
authors.lastname: Walcott
authors.forename: Navid
authors.initials: N
authors.lastname: Redjal
authors.forename: Kristopher T
authors.initials: KT
authors.lastname: Kahle
authors.forename: Brian V
authors.initials: BV
authors.lastname: Nahed
mesh_terms: D005260:Female; D006801:Humans; D008875:Middle Aged; D019635:Neurosurgical Procedures; D016136:Spina Bifida Occulta / Q000601:surgery*; D013131:Spine / Q000601:surgery