Purpose

Congenital dermal sinuses are a rare form of spinal dysraphism. The developmental defects are located along the midline neuroaxis, with sinuses in the cervical region being the least common. Congenital dermal sinuses can be associated with intraspinal infection as they act as a direct route from the skin and subcutaneous tissues into the spinal cord.

Methods

The authors present two cases of cervical dermal sinuses complicated by intramedullary abscess. Both children presented with neurological decline and febrile illness. MRI showed intraspinal abscess. Both underwent prompt surgical excision of the sinus tract, exploration of the cord and intravenous antibiotics.

Results

Both patients demonstrated excellent neurological recovery.

Conclusions

Complete surgical excision of the sinus and tract in addition to long-term antimicrobials can yield excellent neurological outcomes. At surgery, do not expect to find pus when exploring the intramedullary component. Long-term follow-up is advocated due to potential late recurrence.

中文翻译：

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感染先天性颈皮窦导致脊髓脓肿：两例报告及文献复习。

目的

先天性真皮窦是一种罕见的脊柱裂隙症。发育缺陷位于中线神经轴，颈部区域的鼻窦最不常见。先天性真皮鼻窦可能与脊髓内感染有关，因为它们是从皮肤和皮下组织进入脊髓的直接途径。

方法

作者介绍了两例颈部真皮窦并发髓内脓肿的病例。两个孩子都出现了神经功能衰退和发热性疾病。MRI显示椎管内脓肿。两人都接受了鼻窦道的迅速手术切除、脐带探查和静脉注射抗生素。

结果

两名患者都表现出出色的神经功能恢复。

结论

除了长期使用抗菌药物外，鼻窦和尿道的完全手术切除可以产生出色的神经系统结果。在手术中，探索髓内成分时不要期望发现脓液。由于潜在的晚期复发，提倡长期随访。