Human tails: Interdisciplinary treatment for dorsal cutaneous appendages and associated spectrum of spinal dysraphism

• Published in: Interdisciplinary neurosurgery : Advanced techniques and case management 2020-03, Vol.19, p.100632, Article 100632
• Main Authors: Klinge, Petra M., Cho, Daniel, Taylor, Helena O., Morrison, Clinton S., Birgfeld, Craig B., Sullivan, Stephen R.
• Format: Article
• Language: English
• ISSN: 2214-7519; 2214-7519
• DOI: 10.1016/j.inat.2019.100632

•The human tail is a rare congenital anomaly.•Spinal cord tethering is found in up to 50% of patients with a dorsal cutaneous appendage.•Neurologic sequelae of spinal dysraphism vary by age of presentation.•One to three percent of patients with dorsal cutaneous appendage present with multiple anomalies.•Spinal dysraphism can be treated with low morbidity with interdisciplinary care by Plastic Surgery and Neurosurgery. The dorsal cutaneous appendage, or human tail, is a rare congenital anomaly that can span a broad spectrum of tissue and spinal involvement. Associated occult spinal anomalies may not be limited to the lumbar region and can occur at any point along the length of the spinal column. Five cases of human tails are presented with varying degrees of soft tissue anomalies, spinal dysraphism, and neurologic symptoms. Patients range in age from newborn to 22 years. The spectrum of pathology includes those isolated to skin and subcutaneous tissue as well as underlying spinal dysraphism and tethered cord. Surgical treatment ranged from simple tail excisions to microsurgical debulking and spinal cord detethering. The clinical presentation of a lumbosacral appendage should prompt the workup for underlying spinal anomalies at all levels of the spinal cord. Without treatment, the neurologic sequelae of occult spinal dysraphism can be progressive. With proper preoperative evaluation and interdisciplinary treatment, the soft tissue anomaly as well as the spinal dysraphism can be surgically treated to restore function or prevent further neurologic compromise.