Epidermoid Cyst

A spinal epidermoid cyst is a benign, slow-growing, congenital or acquired lesion formed by trapped skin (epithelial) cells within the spinal canal. These cysts contain keratin and cellular debris and are lined by stratified squamous epithelium. Though rare in children, they can cause severe neurological symptoms by compressing the spinal cord or nerve roots as they grow. While these cysts are non-cancerous, early diagnosis and surgical treatment are crucial to avoid permanent neurological deficits, especially in growing children. 🌍 Spinal Epidermoid Cyst in Bangladesh Perspective In Bangladesh, spinal epidermoid cysts are often misdiagnosed or missed entirely due to limited access to advanced spinal imaging (MRI), especially in rural or semi-urban areas. Many children are mistakenly treated for cerebral palsy, muscle disorders, or idiopathic scoliosis without neurological evaluation. Dr. Md. Nafaur Rahman, a trusted pediatric neurosurgeon in Bangladesh, is at the forefront of diagnosing and surgically managing complex spinal lesions like epidermoid cysts using microsurgical excision and intraoperative neuromonitoring at NINS and the Bangladesh Paediatric Neurocare Centre. 🧬 Causes and Risk Factors Congenital origin – due to faulty closure of the neural tube with inclusion of ectodermal cells Acquired causes – post-lumbar puncture or surgery Often associated with: Spina bifida occulta Dermal sinus tracts Tethered cord syndrome 🧒 Clinical Features in Children Depending on the size and location (most commonly lumbar and lumbosacral spine), symptoms may include: Chronic back pain or discomfort Leg weakness or stiffness Unsteady gait, frequent falls Foot deformities (e.g., clubfoot, high-arched feet) Urinary incontinence or retention Constipation or bowel control issues Cutaneous markers like skin dimples, hairy patches, or sinus tracts over the lower spine In some cases, spinal infections or recurrent meningitis may occur if there's a communication with the skin surface. 🔍 Diagnosis 🧠 MRI Spine – Gold Standard Reveals the size, location, and effect on spinal cord/nerves Typically appears as a well-defined lesion with diffusion restriction 🧬 Sinogram or MRI with contrast Used when associated with dermal sinus tract Helps determine if there’s any CSF communication 🧪 Neurological Assessment Evaluation of reflexes, tone, strength, and bladder/bowel control 🛠️ Surgical Treatment ✂️ Microsurgical Excision The mainstay of treatment Goal is total removal of the cyst capsule and contents without damaging spinal cord or nerves Intraoperative neuromonitoring helps preserve neurological function Incomplete excision may lead to recurrence ⚠️ Special Considerations Complete resection may be difficult if the cyst is tightly adhered to neural tissue Any associated dermal sinus tract must be excised to prevent infection 🔄 Postoperative Outcome With timely diagnosis and proper surgery, outcomes are often excellent: Relief from pain and pressure symptoms Improvement in leg strength and walking Recovery of bladder/bowel function (if not long-standing damage) Reduced risk of recurrence with total excision Requires long-term follow-up with MRI for surveillance ⚠️ If Left Untreated Delays in treatment can result in: Permanent paralysis Neurogenic bladder requiring long-term catheterization Orthopedic deformities Recurrent infections or meningitis 👨‍⚕️ Why Choose Dr. Md. Nafaur Rahman? One of Bangladesh’s most experienced pediatric neurosurgeons in treating spinal cystic lesions Expertise in microsurgical and minimally invasive techniques Uses intraoperative neuromonitoring for safe spinal surgery Provides comprehensive care at NINS and Bangladesh Paediatric Neurocare Centre Trusted by families nationwide for ethical, child-friendly, and expert care 📞 Appointment & Consultation Dr. Md. Nafaur Rahman Assistant Professor, Pediatric Neurosurgery, National Institute of Neurosciences & Hospital (NINS) Chief Consultant, Bangladesh Paediatric Neurocare Centre 📞 Call Now: 01912988182 | 01607033535 🌐 Visit: www.neurosurgeonnafaur.com