先天性背部皮肤窦道与硬脊膜内脓肿

目的：探讨隐性脊柱裂中背部皮肤窦道引起硬脊膜内脓肿原因，以及如何早期诊断，及时治疗。方法：本组6例，年龄1－4岁，均为皮肤窦道伴椎客内皮样囊肿继发脓肿形成，诊断领先临床表现及影像学检查，手术行囊肿剥离及窦道切除，术后随访6－20个月，平均15个月。结果：6例患儿中，3例脊髓发育正常患儿，术后2例神经功能恢复正常，1例明显好转；3例脊髓低和，1例双下肢功能恢复，大小便失禁无明显好转，另2例神经功能无明显改善。结论：先天性脊部皮肤窦道可伴有硬脊膜下或髓内皮样囊肿，并感染形成脓肿，因此，对于中枢感染，应及时检查有否背部皮下窦道以及相应的椎管内病变，以利于及时手术，早期诊断，早期治疗有利于神经功能恢复。

Congenital dermal sinus associated with intradural spinal abscess

Objective To study the diagnosis and treatment of intradural abscess secondary to a dermal sinus.Methods Six children aging from 1?4years with dermal sinus and dermoid cyst developed spinal subdural abscesses. The diagnosis depended on clinical signs and radiology examinations. Their treatment involved removal of the dermoid cyst and sinus. The average follow up was 15 months (range: 6 to 20 months).Results Improved neurological functions or full recovery were observed on 4 children ( 66.7% ).Conclusions Dermal sinus accompanied by intradural dermoid cyst can lead to an intradural abscess. Therefore it is advisable to look for a dermal sinus on the back of the child in the case of an infection to the central nervous system. Immediate treatment minimises neurological deficit.