PMC9815783_01
Ostium, computed tomography, and magnetic resonance imaging. (a) Ostium in the midline of the lumbar region (white arrowhead) and computed tomography of the lumbosacral spine and sagittal section revealing a thickening of the vertebral canal, failure in the fusion of the posterior arches and a dermal sinus tract (white arrow); (b) and (c) magnetic resonance imaging, sagittal T2 and STIR (Short Time Inversion Recovery) showing evidence of hypersignal with an intradural lesion from T12 to S1 (white arrows) and cystic dilation of the central medullary canal from T2 to T12 (white arrowhead)
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FIG1
On physical examination, the patient was crying and paraplegic (reduced tone and zero degree of muscle power) and an ostium was observed in the midline of the lumbar region (Figure 1a), along with cutaneous stigmas but no secretion discharge. Computed tomography (CT) of the thoracolumbar spine revealed a thickening of the spinal canal with evidence of spina bifida and a dermal tract (Figure 1a). S1, cystic dilatation of the central medullary canal (hydromyelia) from T2 to T12 (Figures 1b-1c), a posterior fusion defect of the sacral spine and the presence of a dermal tract. The patient underwent a T12-L5 osteoplastic laminotomy (Figure 2a) followed by a durotomy (Figure 2b), which resulted in the drainage of a bulky abscess and improvement of the hydromyelia. Staphylococcus aureus and Escherichia coli were grown on culture.
Intraoperative. (a) Osteoplastic laminotomy (white arrow) with visualization of the dermal sinus tract (white arrowhead); (b) opening of the dural sac with visualization of the roots (white arrow) and drainage of intramedullary purulent discharge (white arrowhead)..
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FIG2
S1, cystic dilatation of the central medullary canal (hydromyelia) from T2 to T12 (Figures 1b-1c), a posterior fusion defect of the sacral spine and the presence of a dermal tract. The patient underwent a T12-L5 osteoplastic laminotomy (Figure 2a) followed by a durotomy (Figure 2b), which resulted in the drainage of a bulky abscess and improvement of the hydromyelia. Staphylococcus aureus and Escherichia coli were grown on culture.