Spinal Dermal Sinus Tract

Spinal dermal sinus tract is a rare form of spinal dysraphism that presents occasionally with signs of spinal tethering and rarely with repeated bouts of bacterial meningitis or fulminant pyogenic infection of the conus medullaris or cauda equina leading to serious loss of neurologic function. Physical examination is crucial to accurately diagnose cutaneous findings such as the presence of a pit or tract, in order to avoid subsequent neurological sequelae. Spinal MR imaging is the only definitive imaging modality for the diagnosis of spinal dermal sinus tract and surgical planning for its excision. Total removal of all dermoid tract material is necessary to prevent recurrence. Careful peri-operative assessment and long-term follow-up will optimize outcomes and minimize complications.