Ahmed Shameem, Dutta Deep, Paul Siba Prosad
Senior Consultant Neurosurgeon, Department of Neurosurgery, Apollo Hospitals, (Unit: International Hospital), Guwahati, India.
Consultant Neurosurgeon,Department of Neurosurgery, Apollo Hospitals, (Unit: International Hospital), Guwahati, India.
Iran J Child Neurol. 2020 Fall;14(4):101-105.
Spinal dysraphism (SD) includes a group of developmental anomalies resulting from failure of fusion of parts along dorsal aspect of midline structures lying along spinal axis from skin to vertebrae and spinal cord. There are two types of SD, open and closed. Close SD, also known as spina bifida occulta, can present with diagnostic challenges in resource limited settings where awareness regarding the condition and specialist radiological investigations, including Magnetic Resonance Imaging (MRI), may not be easily available. Undiagnosed cases can potentially lead to long term morbidities. We report the case of a 13-year old boy with closed SD presenting with recurrent infections of the sacrococcygeal sinus tract which were treated with oral antibiotics for what was considered to be localized infection. Following neurosurgical assessment and spinal MRI a diagnosis of SD was made. He underwent surgical excision of the sinus tract and closure of the defect with good outcome. The case emphasizes the need for awareness regarding SD in children who have sinus tracts in the intergluteal fold with symptoms of recurrent discharge and infection.
脊柱裂（SD）包括一组发育异常，这些异常是由于沿脊柱轴从皮肤到椎骨和脊髓的中线结构背侧部分融合失败所致。SD有两种类型，开放性和闭合性。闭合性SD，也称为隐性脊柱裂，在资源有限的环境中可能会带来诊断挑战，在这些环境中，对该疾病的认识以及包括磁共振成像（MRI）在内的专业放射学检查可能不易获得。未确诊的病例可能会导致长期发病。我们报告了一例13岁患有闭合性SD的男孩，该男孩骶尾部窦道反复感染，曾被认为是局部感染而接受口服抗生素治疗。经过神经外科评估和脊柱MRI检查后，确诊为SD。他接受了窦道手术切除和缺损修复，效果良好。该病例强调了对于臀间皱襞有窦道且伴有反复排液和感染症状的儿童，需要提高对SD的认识。
