Congenital dermal sinus of the cervical spine: clinical characteristics and management.

Congenital dermal sinus (CDS) in the cervical region is extremely rare with only few cases reported in the literature. This study reports a young case of CDS, by which we demonstrate the clinical characteristics and management of cervical CDS, particularly in kids. A 2-year and 7-month-old male child who presented with a one-year history of difficulty in holding objects by hands was diagnosed to have harbored a CDS in the cervical spine since birth. Neurological examination demonstrated mild weakness in both hands and also atrophy in intrinsic hand muscles. Surgery was performed right after diagnosis. Intraoperatively, the sinus tract was totally excised, and untethering was performed. No complications were found after operation. Histopathological examination suggested dorsal dermal sinus. During the follow-up of three years, the patient presented a stable neurologic deficit but did not suffer from an aggravation or improvement of nervous symptoms. At three-year follow-up, the patient was a stable neurologic deficit, and MRI revealed no evidence of the untethered cervical spinal cord and dermal sinus tract. The management strategies of CDS are early surgical treatment to prevent the development of neurological defects.