Pub Date : 2021-05-20DOI: 10.34371/JSPINERES.2020-0038
久敬 生熊, 友彦 廣瀬
{"title":"びまん性特発性骨増殖症（DISH）を伴う胸腰椎骨折に対する椎体終板を貫通させる新しいスクリュー挿入法（Transdiscal Screw for DISH：TSD）と従来法の比較検討","authors":"久敬 生熊, 友彦 廣瀬","doi":"10.34371/JSPINERES.2020-0038","DOIUrl":"https://doi.org/10.34371/JSPINERES.2020-0038","url":null,"abstract":"","PeriodicalId":73951,"journal":{"name":"Journal of spine research and surgery","volume":"88 1","pages":"714-722"},"PeriodicalIF":0.0,"publicationDate":"2021-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83841642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-03-20DOI: 10.1101/2021.03.18.21253916
A. Islam, M. D. Hossain, A. B. Siddik, T. Rahman, A. Alam, M. I. Shourav, N. Afrida, S. Rahman, M. Rahman
Abstract Objective: Anterior spinal artery syndrome (ASAS) has been rarely reported as a complication of intervertebral disc herniation (IVDH). Precipitation factors, presentation, evaluation, treatment strategy, and degrees of recovery have not yet been well documented. Methods: Systematic review was conducted according to PRISMA guidelines to review and summarize for the qualitative synthesis of the data from reported cases of anterior spinal artery syndrome due to intervertebral disc herniation from 1980 to February 2021. Results: A total of 12 cases were reviewed, the median age was 48.5 years. Motor weakness with or without pain was the most frequent presenting symptom accompanying bowel or bladder incontinence (25%) or diminished pain and temperature sensation with spared dorsal column sensation. 40% of conservatively treated patients had complete recovery without any residual deficit. Whereas all patients who managed surgically regained fully functional status with shorter recovery intervals. Conclusion: Abrupt onset of motor weakness is a potential warning symptom of spinal cord infarction, rarely attributed to ASA compression by a herniated disc. Moreover, an accompanying diminished pain and temperature sensation with spared dorsal column sensation is further intimation. Reestablishment of blood flow may bear a favorable outcome.
{"title":"Anterior Spinal Artery Syndrome due to Intervertebral Disc Herniation: A systematic review","authors":"A. Islam, M. D. Hossain, A. B. Siddik, T. Rahman, A. Alam, M. I. Shourav, N. Afrida, S. Rahman, M. Rahman","doi":"10.1101/2021.03.18.21253916","DOIUrl":"https://doi.org/10.1101/2021.03.18.21253916","url":null,"abstract":"Abstract Objective: Anterior spinal artery syndrome (ASAS) has been rarely reported as a complication of intervertebral disc herniation (IVDH). Precipitation factors, presentation, evaluation, treatment strategy, and degrees of recovery have not yet been well documented. Methods: Systematic review was conducted according to PRISMA guidelines to review and summarize for the qualitative synthesis of the data from reported cases of anterior spinal artery syndrome due to intervertebral disc herniation from 1980 to February 2021. Results: A total of 12 cases were reviewed, the median age was 48.5 years. Motor weakness with or without pain was the most frequent presenting symptom accompanying bowel or bladder incontinence (25%) or diminished pain and temperature sensation with spared dorsal column sensation. 40% of conservatively treated patients had complete recovery without any residual deficit. Whereas all patients who managed surgically regained fully functional status with shorter recovery intervals. Conclusion: Abrupt onset of motor weakness is a potential warning symptom of spinal cord infarction, rarely attributed to ASA compression by a herniated disc. Moreover, an accompanying diminished pain and temperature sensation with spared dorsal column sensation is further intimation. Reestablishment of blood flow may bear a favorable outcome.","PeriodicalId":73951,"journal":{"name":"Journal of spine research and surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47935580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-03-03DOI: 10.21203/RS.3.RS-256928/V1
S. Peh, J. Pfarr, J. Schäfer, J. Christensen, A. Chatterjea, R. Nachabe, A. Seekamp, S. Lippross
Background CT is considered the gold standard for detecting pedicle breach. However, CBCT may be a viable and low radiation dose alternative, to provide intraoperative feedback to surgeons to permit in-room revisions of misplaced screws Methods To assess the ability and reliability of intraoperative cone-beam CT (CBCT) from a robotic C-arm in a hybrid operating room (OR) two hundred forty-one pedicle screws were inserted in cervical, thoracic and lumbar spine of 7 cadavers, followed by CBCT and CT imaging. The CT images served as the standard of reference. Agreement on screw placement between both imaging systems was assessed using Cohen’s Kappa coefficient (κ). Sensitivity, Specificity, Receiver operating characteristic (ROC), area under the empirical and fitted ROC curves (AUC) were computed to assess CBCT as a diagnostic tool compared to CT. The patient effective radiation dose (ED) was calculated for comparison. A systematic literature review was performed to provide perspective to the obtained results. Results Almost perfect agreement in assessing pedicle screw grading between CBCT and CT was observed (κ = 0.84). The sensitivity and specificity of CBCT were 0.84 and 0.98, respectively. The AUC derived from the empirical and fitted ROC curves were 0.95 and 0.96, respectively. Conclusion Intraoperative CBCT by C-arm in a hybrid OR is highly reliable in identification of screw placement at significant dose reduction.
{"title":"Intraoperative cone beam CT in hybrid operating room set-up as an alternative to postoperative CT for pedicle screw breach detection","authors":"S. Peh, J. Pfarr, J. Schäfer, J. Christensen, A. Chatterjea, R. Nachabe, A. Seekamp, S. Lippross","doi":"10.21203/RS.3.RS-256928/V1","DOIUrl":"https://doi.org/10.21203/RS.3.RS-256928/V1","url":null,"abstract":"\u0000 Background\u0000\u0000CT is considered the gold standard for detecting pedicle breach. However, CBCT may be a viable and low radiation dose alternative, to provide intraoperative feedback to surgeons to permit in-room revisions of misplaced screws\u0000Methods\u0000\u0000To assess the ability and reliability of intraoperative cone-beam CT (CBCT) from a robotic C-arm in a hybrid operating room (OR) two hundred forty-one pedicle screws were inserted in cervical, thoracic and lumbar spine of 7 cadavers, followed by CBCT and CT imaging. The CT images served as the standard of reference. Agreement on screw placement between both imaging systems was assessed using Cohen’s Kappa coefficient (κ). Sensitivity, Specificity, Receiver operating characteristic (ROC), area under the empirical and fitted ROC curves (AUC) were computed to assess CBCT as a diagnostic tool compared to CT. The patient effective radiation dose (ED) was calculated for comparison. A systematic literature review was performed to provide perspective to the obtained results.\u0000Results\u0000\u0000Almost perfect agreement in assessing pedicle screw grading between CBCT and CT was observed (κ = 0.84). The sensitivity and specificity of CBCT were 0.84 and 0.98, respectively. The AUC derived from the empirical and fitted ROC curves were 0.95 and 0.96, respectively.\u0000Conclusion\u0000\u0000Intraoperative CBCT by C-arm in a hybrid OR is highly reliable in identification of screw placement at significant dose reduction.","PeriodicalId":73951,"journal":{"name":"Journal of spine research and surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42387428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-20DOI: 10.34371/JSPINERES.2020-0019
聖也 渡辺, 和也 内野, 孝昌 三崎, 英明 射場, 一夫 中西
{"title":"Long lateral mass screwの有用性","authors":"聖也 渡辺, 和也 内野, 孝昌 三崎, 英明 射場, 一夫 中西","doi":"10.34371/JSPINERES.2020-0019","DOIUrl":"https://doi.org/10.34371/JSPINERES.2020-0019","url":null,"abstract":"","PeriodicalId":73951,"journal":{"name":"Journal of spine research and surgery","volume":"45 1","pages":"16-21"},"PeriodicalIF":0.0,"publicationDate":"2021-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73103358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BackgroundNon-missile penetrating spinal injuries (NMPSI) can cause delayed neural injury, including cerebrospinal fluid (CSF) leakage and spinal cord herniation, related to dural defects. To repair ventral dural defect (VDD) is particularly challenging in trauma patients and, in a meanwhile, there has been a well-established method: sling technique, used for patients with idiopathic spinal cord herniation (ISCH) in whom VDD being the primary pathology to deal with.Case presentationThis 51-year-old man fell down from an altitude of six meters and landed on a plier. The neurological examination revealed decreased muscle strength (grade 3/3) in bilateral lower extremities. Computed tomography showed a pair of pliers penetrating L4 lamina, spinal canal through vertebral body, psoas muscle into retroperitoneal cavity with inferior vena cava (IVC) indentation. Emergent laparotomy revealed intact IVC with no major organ damage, and the plier was removed from back under direct visualization of IVC. Immediate posterior approach showed a through-and-through VDD. Sling technique with COOK® dura substitute was applied to cover the VDD and fixed with 7-0 prolene after neurolysis. There was no CSF leakage or nerve tissue herniation afterward. He regained working ability with full muscle strength except for a minor sequal of paresthesia of right toe.ConclusionsIn patients with NMPSI with VDD, indirect duraplasty using sling technique originally developed for treating patients with ISCH is suitable and effective in preventing CSF leakage and delayed neural injury. We further propose an algorithm emphasizing key decision makings for repairing dural defect while preventing delayed neural injury.
{"title":"Management of Traumatic Lumbar Meningo-radicular Injury Caused by Foreign Body Penetration using Sling Technique","authors":"Ko-Ting Chen, Ying-Yun Chen, Chieh-Tsai Wu, Tingjie Chang","doi":"10.21203/RS.3.RS-149180/V1","DOIUrl":"https://doi.org/10.21203/RS.3.RS-149180/V1","url":null,"abstract":"\u0000 BackgroundNon-missile penetrating spinal injuries (NMPSI) can cause delayed neural injury, including cerebrospinal fluid (CSF) leakage and spinal cord herniation, related to dural defects. To repair ventral dural defect (VDD) is particularly challenging in trauma patients and, in a meanwhile, there has been a well-established method: sling technique, used for patients with idiopathic spinal cord herniation (ISCH) in whom VDD being the primary pathology to deal with.Case presentationThis 51-year-old man fell down from an altitude of six meters and landed on a plier. The neurological examination revealed decreased muscle strength (grade 3/3) in bilateral lower extremities. Computed tomography showed a pair of pliers penetrating L4 lamina, spinal canal through vertebral body, psoas muscle into retroperitoneal cavity with inferior vena cava (IVC) indentation. Emergent laparotomy revealed intact IVC with no major organ damage, and the plier was removed from back under direct visualization of IVC. Immediate posterior approach showed a through-and-through VDD. Sling technique with COOK® dura substitute was applied to cover the VDD and fixed with 7-0 prolene after neurolysis. There was no CSF leakage or nerve tissue herniation afterward. He regained working ability with full muscle strength except for a minor sequal of paresthesia of right toe.ConclusionsIn patients with NMPSI with VDD, indirect duraplasty using sling technique originally developed for treating patients with ISCH is suitable and effective in preventing CSF leakage and delayed neural injury. We further propose an algorithm emphasizing key decision makings for repairing dural defect while preventing delayed neural injury.","PeriodicalId":73951,"journal":{"name":"Journal of spine research and surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46019885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-15DOI: 10.21203/RS.3.RS-146670/V1
Xinming Yang, Ye Tian, Yao Yao
ObjectiveTo investigate the feasibility and clinical effect of one-stage posterior limited lesion clearance and internal fixation combined with individualized drugs in the treatment of brucidosis spondylitis.Methods44 patients who conform to inclusion criteria, including 2 cases thoracolumbar segment, 32 cases lumbar segment and 10 cases lumbosacral segment. Preoperative VAS(Visua Analogue Scales) 5~8,ODI(Oswestry disability index) 51.15~84.36%, Body Mass Index （BMI） 16.2~17.5, American Spinal Injury Association（ASIA）classification C grade 6 and D grade 10. Magnetic Resonance Imaging（MRI） showed compression of dural sac in 16 cases. Preoperative medication regimen was developed according to the patient's medication allergy history, weight, liver and kidney function, and T-lymphocyte spot test（T-SOPT）.ResultsPostoperative individualized medication was used according to the drug sensitivity test and T-SOPT to select 3 kinds of sensitive drugs for 2 courses of treatment, and the patients were clinically cured 3 to 9 months. The evaluation indexes of Erythrocyte Sedimentation Rate （ESR）, C-reactive protein （CRP）, Rose Bengal Plate agglutination Test （RBPT）, VAS,BMI,ASIA,ODI and MRI at each time point were significantly improved compared with those before surgery (P<0.05). Follow-up showed that the lesions were completely cleared, inflammation was absorbed, pedicle screw fixation was good, spine stable, intervertebral bone grafting was fused, and the spinal cord were well aligned without compression.ConclusionPersonalized medication is highly targeted, conforms to pharmacokinetics, has low toxic and side effects, no drug allergy or drug resistance, so as to reduce medical expenses and obtain the maximum clinical efficacy with the minimum cost. One-stage posterior limited lesion clearance and internal fixation surgery has little trauma, and the lesions are completely removed. The correct choice of screw placement and short segment internal fixation of diseased vertebra is safe and reliable.
{"title":"Establishment and Clinical Application of One-stage Posterior Limited Lesion Clearanceand Internal Fixation Combined With Personalized Drug Therapy System for Brucellosis Spondylitis","authors":"Xinming Yang, Ye Tian, Yao Yao","doi":"10.21203/RS.3.RS-146670/V1","DOIUrl":"https://doi.org/10.21203/RS.3.RS-146670/V1","url":null,"abstract":"\u0000 ObjectiveTo investigate the feasibility and clinical effect of one-stage posterior limited lesion clearance and internal fixation combined with individualized drugs in the treatment of brucidosis spondylitis.Methods44 patients who conform to inclusion criteria, including 2 cases thoracolumbar segment, 32 cases lumbar segment and 10 cases lumbosacral segment. Preoperative VAS(Visua Analogue Scales) 5~8,ODI(Oswestry disability index) 51.15~84.36%, Body Mass Index （BMI） 16.2~17.5, American Spinal Injury Association（ASIA）classification C grade 6 and D grade 10. Magnetic Resonance Imaging（MRI） showed compression of dural sac in 16 cases. Preoperative medication regimen was developed according to the patient's medication allergy history, weight, liver and kidney function, and T-lymphocyte spot test（T-SOPT）.ResultsPostoperative individualized medication was used according to the drug sensitivity test and T-SOPT to select 3 kinds of sensitive drugs for 2 courses of treatment, and the patients were clinically cured 3 to 9 months. The evaluation indexes of Erythrocyte Sedimentation Rate （ESR）, C-reactive protein （CRP）, Rose Bengal Plate agglutination Test （RBPT）, VAS,BMI,ASIA,ODI and MRI at each time point were significantly improved compared with those before surgery (P<0.05). Follow-up showed that the lesions were completely cleared, inflammation was absorbed, pedicle screw fixation was good, spine stable, intervertebral bone grafting was fused, and the spinal cord were well aligned without compression.ConclusionPersonalized medication is highly targeted, conforms to pharmacokinetics, has low toxic and side effects, no drug allergy or drug resistance, so as to reduce medical expenses and obtain the maximum clinical efficacy with the minimum cost. One-stage posterior limited lesion clearance and internal fixation surgery has little trauma, and the lesions are completely removed. The correct choice of screw placement and short segment internal fixation of diseased vertebra is safe and reliable.","PeriodicalId":73951,"journal":{"name":"Journal of spine research and surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49454666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Luis Díez-Albero, María Tíscar García-Ortiz, Miguel A. Bañuls-Pattarelli, R. Mulholland, F. Lopez-Prats
Purpose: Description of a non-operative technique for the repair of cerebrospinal (CSF) dural leaks after lumbar spine surgery. Methods: Two patients, thirty-nine and seventy-six years old respectively, were previously operated of lumbar discectomy/decompression, and in the following days developed leakage of clear CSF fluid in their surgical wounds. They were treated by means of stitched pads to their wounds, creating continuous external compression reducing the dead space for the CSF to get in. J Spine Res Surg 2021; 3 (4): 106-112 DOI: 10.26502/fjsrs0035 Journal of Spine Research and Surgery 107 Results: After, one and two weeks respectively and no evidence of leakage the sutures were removed. The patients were reviewed at 3 and 6-months post operation, where no clinical evidence of dural leaks was found and in one the MRI confirm their absence. At the end, the patients were asymptomatic of their original lumbar complaint. Conclusion: An alternative simple technique that avoids the necessity of reoperation in the case of postoperative dural tears.
{"title":"Continuous Mechanical External Compression for Dural Leaks after Lumbar Spine Surgery by Stitching Pads to the Wound, A Conservative Treatment. Report of Two Cases","authors":"Luis Díez-Albero, María Tíscar García-Ortiz, Miguel A. Bañuls-Pattarelli, R. Mulholland, F. Lopez-Prats","doi":"10.26502/fjsrs0035","DOIUrl":"https://doi.org/10.26502/fjsrs0035","url":null,"abstract":"Purpose: Description of a non-operative technique for the repair of cerebrospinal (CSF) dural leaks after lumbar spine surgery. Methods: Two patients, thirty-nine and seventy-six years old respectively, were previously operated of lumbar discectomy/decompression, and in the following days developed leakage of clear CSF fluid in their surgical wounds. They were treated by means of stitched pads to their wounds, creating continuous external compression reducing the dead space for the CSF to get in. J Spine Res Surg 2021; 3 (4): 106-112 DOI: 10.26502/fjsrs0035 Journal of Spine Research and Surgery 107 Results: After, one and two weeks respectively and no evidence of leakage the sutures were removed. The patients were reviewed at 3 and 6-months post operation, where no clinical evidence of dural leaks was found and in one the MRI confirm their absence. At the end, the patients were asymptomatic of their original lumbar complaint. Conclusion: An alternative simple technique that avoids the necessity of reoperation in the case of postoperative dural tears.","PeriodicalId":73951,"journal":{"name":"Journal of spine research and surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69348028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Fusion Rate for Single Level ACDF with and without Plating in Degenerative Disc Disease, Tracing the Results","authors":"A. Ismail, Muhammad Mohsin khan","doi":"10.26502/fjsrs0036","DOIUrl":"https://doi.org/10.26502/fjsrs0036","url":null,"abstract":"","PeriodicalId":73951,"journal":{"name":"Journal of spine research and surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69348064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ghanem Al Sulaiti, Muhammad Mohsin khan, Ghaya Al rumaihi, A. E. El Beltagi, Issam El Bozom, Doaa Mohammed Taha, S. Magboul, Kazim Mohammed
Cystic mature teratomas presenting in the spine are rare, comprising less than 0.1% of all spinal tumors. They arise from all three germ cell layers and usually accompany other congenital abnormalities. Spinal teratomas are more common in children as compared to adults and are usually associated with spinal dysraphism. Dermal Sinus is a closed type of Spinal dysraphsim, lined with epithelium and are mostly associated with Dermoid, Epidermoid and Posterior arch defect [1]. We present a case of an infant with recurrent meningitis. His examination was remarkable for a lumbar dimple. Imaging revealed a dermal sinus track continuous with a dumbbell appearance of extradural and intradural nodules, while the histopathology confirmed mature cystic Teratoma. J Spine Res Surg 2021; 3 (3): 099-105 DOI: 10.26502/fjsrs0034 Journal of Spine Research and Surgery 100
{"title":"Dermal Sinus Track with Intraspinal Dumbbell Mature Cystic Teratoma in an Infant Presenting as Recurrent Meningitis: A Case Report","authors":"Ghanem Al Sulaiti, Muhammad Mohsin khan, Ghaya Al rumaihi, A. E. El Beltagi, Issam El Bozom, Doaa Mohammed Taha, S. Magboul, Kazim Mohammed","doi":"10.26502/fjsrs0034","DOIUrl":"https://doi.org/10.26502/fjsrs0034","url":null,"abstract":"Cystic mature teratomas presenting in the spine are rare, comprising less than 0.1% of all spinal tumors. They arise from all three germ cell layers and usually accompany other congenital abnormalities. Spinal teratomas are more common in children as compared to adults and are usually associated with spinal dysraphism. Dermal Sinus is a closed type of Spinal dysraphsim, lined with epithelium and are mostly associated with Dermoid, Epidermoid and Posterior arch defect [1]. We present a case of an infant with recurrent meningitis. His examination was remarkable for a lumbar dimple. Imaging revealed a dermal sinus track continuous with a dumbbell appearance of extradural and intradural nodules, while the histopathology confirmed mature cystic Teratoma. J Spine Res Surg 2021; 3 (3): 099-105 DOI: 10.26502/fjsrs0034 Journal of Spine Research and Surgery 100","PeriodicalId":73951,"journal":{"name":"Journal of spine research and surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69348019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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