Lumbar back sinus

Introduction Congenital skin-like sinus: common in the head pillow or waist, back midline. Patients with cochlear spina bifida can have both endothelium-like or epithelial congenital masses. This sinus is more common in the lumbosacral region, and the local soft tissue can be slightly raised. The skin around the small hole in the sinus can be seen as pale red pigmentation and surrounded by tufts. Occasionally fine hair protrudes from the small hole. Sometimes a little liquid seeps out. When secondary infection, local redness, swelling, and pain.

Cause

The cause of the lower back sinus:

(1) Causes of the disease: The pathogen is Streptococcus pneumoniae, and there are 83 kinds of serotypes. Type I, II, and III are highly pathogenic. The other types of pathogenicity are weak or non-virulent, mostly upper respiratory parasites. Pneumococci are warhead-shaped and have a diameter of about 0.5 to 1.5 m. When arranged in double, the blunt ends or tips are opposite. Sometimes arranged in a short chain or in a single presence. A capsule can be formed in the body. In the ordinary stained specimen, since the capsule is not easily colored, a semi-transparent shadow which is not colored is formed around the periphery of the bacteria. This capsule can be dyed by special staining to help identify it. Streptococcus pneumoniae does not produce exotoxin, and its pathogenicity mainly depends on the invasion of the capsule. After infection, the body can obtain short-term immunity, easy to relapse, recurrence, and a variety of bacterial types, short immunization period.

(B) the pathogenesis: pus and adhesions are concentrated on the surface of the brain, the top is more, like a cap, less pus in the bottom of the brain. Late stage lesions are more common and severe. Common complications include subdural effusion or empyema. Longer course of the disease can cause the ventricles to expand and even form hydrocephalus.

an examination

Related inspection

Bone marrow analysis

Examination and diagnosis of the back and back sinus:

1. Cerebrospinal fluid examination: In severe or advanced cases, the pus in the spinal canal is sticky and not easy to flow out. If the needle tip has entered the spinal cavity during lumbar puncture, the cerebrospinal fluid does not flow out. You can inject a small amount of normal saline and wash it repeatedly, and carry out routine examination and bacterial culture of the eluate. In some cases, the degree of cerebrospinal fluid opacity is not serious, even a few sputum, the number of cells is only a few hundred, but a large number of S. pneumoniae can be seen under the smear staining microscope (indicating a serious disease).

2. Antigen detection: In the absence of bacteria, the detection of S. pneumoniae-specific DNA by PCR can confirm the diagnosis. The Danish Serum Institute is the only unit in the world that produces a full set of serum. Omni serum includes type 83, which can be used. Perform antigen detection. However, the Type 7, 14 cannot be detected by the CIE method. The LA and CoA methods can detect all S. pneumoniae.

3. Blood examination: peripheral blood has a significant increase in white blood cells and neutrophils.

Should be X-ray, B-ultrasound, brain CT and other examinations.

Differential diagnosis

Symptoms of complication in the lower back sinus:

Open neural tube insufficiency is also called open spine fissure, which usually occurs in the lumbosacral region, local spinal canal dehiscence, and the content of the spinal canal bulges from the rupture to the rear. According to the content of the bulging, it is divided into two types: spinal bulging and spinal meningocele.

The dorsal skin sinus terminates in a dermoid cyst or epidermoid cyst. The skin sinus is often susceptible to secondary infections, causing meningitis or subcutaneous abscesses.

The congenital malformation is a congenital malformation. Although it is also a collateral nerve in the lumbosacral region, it has skin coverage, and the nerve tissue is not exposed to the air.

Meningocele; swell of spinal cord cyst; the deformity of the sinus of the lumbar back skin is due to the fact that the superficial ectoderm (skin tissue) of the embryonic period and the ectoderm forming the nerve tissue are not completely separated, leaving a local adhesion zone. During later development, the spinal cord is surrounded by mesenchymal tissue and displaced upwards in the later formed bone spinal canal. The adhesive band continues to form a long tubular structure with the inner wall of the tube. One connects the spinal cord and one connects the skin. There are depressions or small holes in the surface of the skin, combined with hair, hemangioma or pigmentation. Mostly located in the lumbosacral region, followed by the occipital region. The sinus terminates in the subcutaneous tissue, the dura mater, the subarachnoid space, the spinal cord, or the nerve roots. Approximately 50% of cases of the lumbar dorsal skin sinus terminate in a dermoid cyst or epidermoid cyst. The skin sinus is often susceptible to secondary infections, causing meningitis or subcutaneous abscesses. The deformity of the sinus of the lumbar back skin is due to the fact that the superficial ectoderm (skin tissue) and the ectoderm forming the nerve tissue are not completely separated during the embryonic period, leaving a local adhesion zone. During later development, the spinal cord is surrounded by mesenchymal tissue and displaced upwards in the later formed bone spinal canal. The adhesive band continues to form a long tubular structure with the inner wall of the tube. One connects the spinal cord and one connects the skin. There are depressions or small holes in the surface of the skin, combined with hair, hemangioma or pigmentation. Mostly located in the lumbosacral region, followed by the occipital region. The sinus terminates in the subcutaneous tissue, the dura mater, the subarachnoid space, the spinal cord, or the nerve roots.

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