CASE PRESENTATION:
A 7-day-old male baby was admitted with a history of an abnormal skin lesion on his lower back. The skin lesion was flat, with no swelling or discharge. Physical examination revealed a skin lesion which was flat with a dimple at the sacrum level resembling a cigarette burn (Figure 1 ). A spinal MRI revealed a fibro neural tract extending from the skin surface into the lumbar spinal canal at the level of L5-S1 with a syringohydromyelia and neurogenic bladder (Figure 2 ).
According to the Neurological grading system of LDMs [5], he had a grade 2 defect. Excision of skin lesion/tract and untethering of filum with dural tube reconstruction under INOM guidance was performed.