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Child's Nervous System

, Volume 1, Issue 1, pp 3–11 | Cite as

Surgically confirmed myelographic classification of congenital intraspinal lipoma in the lumbosacral region

  • Kiyoshi Sato
  • Takeyoshi Shimoji
  • Hirotoshi Sumie
  • Katsumi Yaguchi
  • Akira Yagishita
  • Yutaka Kuru
  • Shozo Ishii
Invited Papers

Abstract

Twenty-four cases of histologically confirmed congenital intraspinal lipoma of the lumbosacral region were studied by means of myelography with metrizamide. The findings were compared with intraoperative observations. Myelography with metrizamide clearly revealed the detailed intrathecal structures and allowed a classification of intraspinal lipomas into four types, in terms of their insertion into the conus medullaris: (1) dorsal type, either with direct or indirect (via an intrathecal stalk) insertion of the extrathecal lipoma into the dorsal aspect of the conus medullaris; (2) caudal type; (3) combined type; and (4) filar lipoma. Based on our surgical experience in untethering and decompression of the lesions, the classification was found to be useful in designing a safe and effective surgical procedure which minimized all possible trauma to the intrathecal neural structures.

Key words

Intraspinal lipoma Myelography Meningocele 

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References

  1. 1.
    Anderson FM (1968) Occult spinal dysraphism: diagnosis and management. J Pediatr 73:163–177Google Scholar
  2. 2.
    Barry JF, Harwood-Nash DC, Fitz CR, Byrd DW (1977) Metrizamide in pediatric myelography. Radiology 124:409–418Google Scholar
  3. 3.
    Barson AJ (1969) Vertebral level of termination of spinal cord during normal and abnormal development. J Anat 106:489–497Google Scholar
  4. 4.
    Bassett RC (1950) The neurologic deficit associated with lipomas of the cauda equina. Ann Surg 131:109–116Google Scholar
  5. 5.
    Bruce DA, Schut L (1979) Spinal lipomas in infancy and childhood. Child's Brain 51:192–203Google Scholar
  6. 6.
    Burrows FGO (1968) Some aspects of occult spinal dysraphism: a study of 90 cases. Br J Radiol 41:496–507Google Scholar
  7. 7.
    Chapman PH (1982) Congential intraspinal lipomas: anatomic considerations and surgical treatment. Child's Brain 9:37–47Google Scholar
  8. 8.
    Dubowitz V, Lorber L, Zachary RB (1965) Lipoma of the cauda equina. Arch Dis Child 40:207–213Google Scholar
  9. 9.
    Emery JL, Lendon RG (1969) Lipomas of the cauda equina and other fatty tumors related to neurospinal dysraphism. Dev Med Child Neurol [Suppl] 11:62–70Google Scholar
  10. 10.
    Fitz CR, Harwood-Nash DC (1975) The tethered conus. AJR 125:515–523Google Scholar
  11. 11.
    Gold LHA, Kieffer SA, Peterson HO (1969) Lipomatous invasion of the spinal cord associated with spinal dysraphism: myelographic evaluation. AJR 107:479–485Google Scholar
  12. 12.
    Gryspeerdt GL (1963) Myelographic assessment of occult forms of spinal dysraphism. Acta Radiol [Diagn] (Stockh) 1:702–717Google Scholar
  13. 13.
    Hoffman HJ, Hendrick EB, Humphreys RP (1976) The tethered spinal cord: its protean manifestations, diagnosis and surgical correction. Child's Brain 2:145–155Google Scholar
  14. 14.
    Lassman LP, James CCM (1967) Lumbosacral lipomas: critical survey of 26 cases submitted to laminectomy. J Neurol Neurosurg Psychiatry 30:174–181Google Scholar
  15. 15.
    Naidich TP, McLone DG, Mutluer S (1983) A new understanding of dorsal dysraphism with lipoma (Lipomyeloschisis): radiologic evaluation and surgical correction. AJNR 4:103–166Google Scholar
  16. 16.
    Roger HM, Long DM, Chou SN, French LA (1971) Lipomas of the spinal cord and cauda equina. J Neurosurg 34:349–354Google Scholar
  17. 17.
    Till K (1973) Occult spinal dysraphism. The value of prophylactic surgical treatment. Excerpta Medica, AmsterdamGoogle Scholar
  18. 18.
    Villarejo FJ, Blazquez MG, Gutierrez-Diaz JA (1976) Intraspinal lipomas in children. Child's Brain 2:361–370Google Scholar

Copyright information

© Springer-Verlag 1985

Authors and Affiliations

  • Kiyoshi Sato
    • 1
  • Takeyoshi Shimoji
    • 1
  • Hirotoshi Sumie
    • 1
  • Katsumi Yaguchi
    • 1
  • Akira Yagishita
    • 2
  • Yutaka Kuru
    • 1
  • Shozo Ishii
    • 1
  1. 1.Department of Neurological Surgery and Department of RadiologyThe Juntendo University HospitalTokyoJapan
  2. 2.Department of RadiologyMetropolitan Hiroo General HospitalTokyoJapan

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