Case Report

The evaluation and surgical treatment of sacral dermal sinus tracts in children

  • Cahit Kural
  • Serhat Pusat
  • İlker Solmaz
  • Serdar Kaya
  • Cenk Kılıç
  • Yusuf İzci

Received Date: 17.12.2010 Accepted Date: 03.02.2011 Gulhane Med J 2011;53(4):284-289

The aim of this article was to emphasize how to manage children with sacral dermal sinus tracts and the important aspects of surgery. In all of the 5 children operated because of dermal sinus tracts between 2005 and 2009 the tracts had lied to the dural sac, attached to the filum terminale, and caused tethered cord. The tracts were followed and the laminectomy was performed at the entrance point to the spinal canal. After opening the dura, the point at which tract tied was identified and released by cutting. Additionally nevre roots around the region were released by cleaning from arachnoid adhesions and fibrous bands. Dermoid tumor and spinal lipoma were removed from intradermal region in two patients. No complications were observed in any patients. The level of conus medullaris relatively rose in 3 patients during the follow-up. Sacral dermal sinus tracts in children are important pathologies that require meticulous evaluation. Magnetic resonance imaging should absolutely be performed. Surgical treatment should be performed if the sacral dermal sinus tracts cause tethered cord syndrome. The sinus tract should be followed until the dura and intradural region, and released from the attachment place in these cases. The sacral rootlets should be released from the surrounding arachnoid and fibrous bands during surgery.

Keywords: Surgery, dermal sinus tract, tethered cord, sacral region