Analytical Study of Occult Spinal Dysraphism - Its Varied Presentations, Management and Outcome in South Indian Population
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2017, Vol 5, Issue 1
Abstract
Abstract Introduction: Occult spinal dysraphism (OSD) represents a subset of spinal dysraphism in which the congenital defects are covered by intact skin. The risk of neurologic deterioration exists at all ages and increases with time and is frequently progressive. The detection and early treatment of such a subtle cutaneous anomaly in a child may be crucial to future neurologic, urologic, and orthopedic development. Aim: To know demographics, presenting symptoms, clinical features, imaging, and surgical findings of the patients presented with OSD and to assess the outcome and to establish the necessity of surgery before the development of neurological deficits. Methods: This study was conducted at Department of Neurosurgery, GRH, Madurai, during 2007-2011. A total of 50 patients presented with OSD were evaluated. Age, sex, presenting complaint, past history, cutaneous findings, neurological deficits, imaging findings, associated abnormalities, and outcome of surgery were assessed. Results: Congenital dermal sinus was presented in 29 out of 50 patients (58%). The most common location of congenital dermal sinus tract in this study was lumbar region. The least common location of the sinus was at cervical region. 18 patients (36%) presented with neurological deficit. All patients had undergone surgical management with detethering. All patients were followed up at regular interval for 2-30 months. One patient developed recurrence of dermoid and another one showed deterioration of motor and autonomic deficits with the presence of pus in the tract. There were no symptoms of worsening or evidence of retethering in all other patients. Conclusion: The presence of cutaneous stigmata over the midline neural axis should not be considered benign and must initiate prompt radiologic evaluation and neurosurgical referral. All patients with OSD should be offered aggressive surgical treatment. Key words: Congenital dermal sinus, Dermoid, Detethering, Occult spinal dysraphism
Authors and Affiliations
K Siva Kumar
Keywords
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