Spinal dermal sinuses and dermal sinus-like stalks analysis of 14 cases with suggestions for embryologic mechanisms resulting in dermal sinus-like stalks

Eur J Paediatr Neurol. 2013 Nov;17(6):575-84. doi: 10.1016/j.ejpn.2013.04.003. Epub 2013 May 24.


Background: Spinal dermal sinuses consist of an epithelium-lined tract extending from the skin towards the spinal cord, often resulting in infections or tethered cord syndrome. Recently, a variant called dermal sinus-like stalk was described as an analogous tract but not containing an epithelium-lined lumen.

Aims: We aimed to describe the findings in our patients, subdivide our specimens into both conditions, compare the characteristics of both groups and search for possible embryologic mechanisms of dermal sinus-like stalks.

Methods: We performed a retrospective analysis of all patients operated in our hospital for both conditions between 1996 and 2012.

Results: 14 patients were operated upon for spinal dermal sinuses (n = 5) and spinal dermal sinus like-stalks (n = 9). Patients were mainly referred from other hospitals due to skin abnormalities and were evaluated at mean age of 7 weeks and operated upon at mean age of 1 year and 2 months. Primary reason for referral was skin abnormalities in both groups, though there were two cases of meningitis in dermal sinus patients and 2 of recurrent urinary tract infections in dermal sinus-like stalk patients. Consistent with previous findings, dermal sinus-like stalk patients do not have a history of meningitis, lack dermoid or epidermoid tumours along their tract, and are histologically of pure mesodermal origin. Dermal sinus-like stalks might result from interposition of mesenchyme during primary or secondary neurulation.

Conclusions: We consider dermal sinus-like stalks as a rare but currently under diagnosed condition with different clinical, pathological and probably also embryologic characteristics compared to spinal dermal sinuses.

Keywords: Dermal sinus tract; Dermal sinus-like stalk.

MeSH terms

  • Dura Mater / pathology
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Infant, Newborn
  • Magnetic Resonance Imaging
  • Male
  • Skin Abnormalities / complications*
  • Skin Abnormalities / pathology*
  • Skin Neoplasms / pathology*
  • Spinal Cord Diseases / complications*
  • Spinal Cord Diseases / diagnosis*
  • Spinal Cord Diseases / surgery
  • Urologic Diseases / complications*
  • Urologic Diseases / surgery