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Gulhane Med J. 2011; 53(4): 284-289

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

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

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.

Key words: Surgery, dermal sinus tract, tethered cord, sacral region

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