Outcome of Therapies for Dermal Sinus Tracts in Children

Outcome After Surgery

• 25/28 improved or unchanged: In the largest single series only 3 of 28 patients were worse after their surgery for a dermal sinus tract. Two had worsening of urological function, and one experienced motor weakening (2). 14 of 28 were unchanged with surgery, with 11 of these patients being normal both before and after surgery. 11 of the 28 experienced neurological improvement with surgery.
• Dependent on preoperative status: Prognosis is dependent on the preoperative neurological status of the patient. The prognosis is better for patients without associated tumor, abscess (especially intramedullary), or neuro-urological deficits (16). Most patients become free of disease with little chance of recurrence.
• Risks of retethering and infection rise with complexity of presentation: The more complex the clinical situation or surgery, the higher the likelihood of retethering or reinfection (16). This is particularly important when the presenting sign is infection, as the risk of intraoperative and postoperative adhesions is high, which may lead to increased intraoperative complications and future retethering.