Radical excision of lumbosacral lipoma: an early experience of “followers”
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Indication, timing, and method for surgical treatment of lumbosacral lipoma are controversial. Radical resection of the lumbosacral lipoma and complete reconstruction of the placode are supported in that better long-term outcome can be achieved without increasing complication rate compared with traditional surgical techniques.
We analyzed the early surgical outcomes of lumbosacral lipoma treated with the untethering and radical excision of fat.
Retrospective analysis of surgically treated 81 fresh lumbosacral lipoma cases with dorsal, transitional, and chaotic types and true lipomyelomeningocele (LMMC) was performed. Caudal and filar types were excluded.
Complete untethering was accomplished in 98%. Radical excision of the lipoma was attempted in all cases and achieved in 83%. Postoperative neurological complication was observed in 8 cases (10%). Group of lipoma types (dorsal + transitional vs. chaotic + true LMMC) and availability of radical lipoma excision turn out to be factors related to neurological outcomes in univariate analysis (p < 0.001 and p = 0.027, respectively). Group of lipoma types, availability of radical excision, and postoperative cord/dural sac (C/D) ratio are related factors in multivariate analysis (p = 0.025, p = 0.049, and p = 0.031).
As a follower of untethering and radical excision of fat, careful consideration is required to plan the surgery of lumbosacral lipoma on account of the “underestimated” complication rate. Type of the lipoma is the important factor determining the surgical outcome. Availability of complete radical excision and postoperative C/D ratio are the operative factors related to the neurological outcomes.
KeywordsLumbosacral lipoma Neurological outcome Radical excision Complications Untethering
This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (2015R1A2A1A15055781).
Compliance with ethical standards
This study was approved by the Institutional Review Board (IRB) of the hospital. The waiver of consent was granted under IRB review.
Conflict of interest
There are no conflicts of interests.
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