Successful Neonatal, Intraoperative Neuromonitoring in the Surgical Correction of a Thoracic Dermal Sinus Tract: Technical Note

Pediatr Neurosurg. 2022;57(4):295-300. doi: 10.1159/000524924. Epub 2022 May 5.

Abstract

Introduction: Intraoperative neuromonitoring (IONM) is commonly used during surgery of the spine and spinal cord for early surveillance of iatrogenic injury to the central and peripheral nervous system. However, for infants and young children under 3 years of age, the use of IONM is challenging due to incomplete central and peripheral myelination.

Case presentation: We report a case of a T4-T6 dermal sinus tract (DST) that was resected on day of life 23, with the successful use of IONM.

Conclusion: To our knowledge, this is the youngest reported case of the use of IONM in the surgical correction of a DST in a neonatal patient. This case demonstrates the potential efficacy of IONM in neonatal spine surgery and the techniques used to adapt the technology to an immature nervous system.

Keywords: Intraoperative neuromonitoring; Neonatal patient; Spine surgery; Thoracic dermal sinus tract.

Publication types

  • Case Reports

MeSH terms

  • Child
  • Child, Preschool
  • Evoked Potentials, Motor / physiology
  • Fistula*
  • Humans
  • Infant
  • Infant, Newborn
  • Intraoperative Neurophysiological Monitoring* / methods
  • Neurosurgical Procedures / methods
  • Retrospective Studies
  • Spina Bifida Occulta* / diagnostic imaging
  • Spina Bifida Occulta* / surgery
  • Spine