Spinal intramedullary abscess secondary to dermal sinus in children

Prasad, Lakshmi G and Hegde, Ajay and Divya, S (2019) Spinal intramedullary abscess secondary to dermal sinus in children. European Journal of Pediatric Surgery, 29 (3). pp. 229-238. ISSN 0939-7248

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Introduction Congenital dermal sinuses (CDS) are uncommon lesions. They are most often noted in lumbosacral region and may lead to meningitis or spinal abscess. Intramedullary spinal cord abscess (IMSCA) due to CDS is rare and often co-exists with an inclusion tumor such as dermoid/epidermoid cyst. Materials and Methods: Literature review was done to analyze all cases of pediatric IMSCA secondary to CDS by searching online databases starting from the oldest case reported. Results: Only 50 cases have been reported and were analyzed. Mean age was 22.6 months (range 1 month–15 years). Fever, acute flaccid lower limb weakness, and urinary disturbances were the most common presenting features. Dermal sinus was commonest in lumbosacral region. Inclusion cysts were observed in 50% of cases. Staphylococcus aureus was the most the common organism. Mean follow-up duration was 18.2 months (range 1 week–156 months). Majority of the cases underwent multilevel laminectomy with myelotomy and drainage of abscess. Outcome was goodto- excellent in around 60% cases with four deaths. Presence of fever and limb weakness was significantly associated with poor outcomes. Conclusion: Intramedullary abscess secondary to CDS is very rare. Complete sinus tract excision, myelotomy and drainage of abscess, and decompression of co-existent inclusion cysts with prolonged antibiotic therapy remain the standard treatment. Approximately 60% cases achieve good outcomes. Fever and limb weakness portend poorer outcomes than those without.

Item Type: Article
Uncontrolled Keywords: Spinal abscess; intramedullary abscess; pediatric; dermal sinus; review.
Subjects: Dentistry > MCODS Manipal > Orthodontics
Medicine > KMC Manipal > Neuro Surgery
Depositing User: KMC Library
Date Deposited: 24 May 2019 03:50
Last Modified: 24 May 2019 03:50
URI: http://eprints.manipal.edu/id/eprint/153832

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