Resection of a dermal sinus tract
T2-weighted sagittal MRI of lumbosacral spine: Shown is tract in subcutaneous layers (left) and intramurally (right).
Cutaneous dimple of dermal sinus tract: Shown is the dimple of a dermal sinus tract just above the gluteal fold.
Detachment of dermal sinus from surrounding skin
The cutaneous dimple is removed by elliptically incising the dermal layer around it. The incision is then extended down to the spinal fascia taking care not to cut through the sinus tract.
Exposing tract’s penetration of paraspinal fascia
The spinous processes and lamina overlying the intramural portion of the dermal sinus tract are then exposed.
Laminotomy
The lamina can be freed from the lateral elements of the spine in a fashion that allows their reattachment at the time of wound closure.
Opening dura around dermal sinus tract
The dura is opened elliptically around the sinus tract and then extended rostrally to expose the length of the intramural component of the sinus tract.
Sectioning of filum
After the tract is removed the film terminale is sectioned.
Closure
The dura is closed. The laminar roof can be reattached to the spine and the incision then is closed in the routine manner
Please create a free account or log in to read 'Resection of Dermal Sinus Tract – Bermans J. Iskandar, M.D.'
Registration is free, quick and easy. Register and complete your profile and get access to the following:
- Full unrestricted access to The ISPN Guide
- Download pages as PDFs for offline viewing
- Create and manage page bookmarks
- Access to new and improved on-page references
