Complicated congenital dermal sinus: Diagnosis and management

•Ten patients studied, 2 females (20%) and 8 males (80%). Age range (13–48 months).•90%present by paraparesis. Symptoms duration ranges from 4 to 12 days, mean = 5 days.•All patients underwent drainage of pus collections with dermal sinus track excision.•Staphylococcus spp. was the most common organism responsible for infection.•6 patients recovered completely, while 4 cases showed residual deficits. Congenital dermal sinus tracts of the spine are a rare form of spinal dysraphism, and should be considered in the differential diagnosis of lumbar subcutaneous abscesses, The CDS tracts can be associated with several pathological findings, including inclusion tumors (for example, epidermoid, dermoid, and teratoma), split-cord malformations, and tethered spinal cords. Excision of the sinus and its track with untethering of the cord should be done as early as possible to avoid intraspinal infection and abscess formation. Our study aims to find out the value of early diagnosis & rapid management of complicated CDS, to re-establish neurological function. Ten cases (2 females and 8 males), with age range (13 months −4 years) presented with acute paraparesis and one case of quadriparesis, MRI spine showed spinal abscess, operative drainage was done with excision of the dermal sinus and track. Neurological deficits improved in all cases, but 4 cases showed residual deficits, while the other 6 cases got complete recovery. Establishing diagnosis and rapid management of abscess complicating a congenital dermal sinus, is crucial to restore neurological function.