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ISPN GuideCongenital Disorders of the Nervous System in ChildrenDermal Sinus Tracts in Children HomepageManagement of Dermal Sinus Tracts in ChildrenTips and Techniques for Dermal Sinus Tracts in ChildrenBermans J. Iskandar, M.D. – Video of Resection

Bermans J. Iskandar, M.D. – Video of Resection

This page was last updated on May 9th, 2017

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.
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Tips and Techniques for Dermal Sinus Tracts in Children
Farideh Nejat, M.D. – Tip