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Child's Nervous System

, Volume 16, Issue 3, pp 143–149 | Cite as

Factors in neurological deterioration and role of surgical treatment in lumbosacral spinal lipoma

  • I. Koyanagi
  • Y. Iwasaki
  • K. Hida
  • H. Abe
  • T. Isu
  • M. Akino
  • T. Aida
Original Paper

Abstract 

The purpose of this study was to determine factors that might be involved in neurological deterioration and the role of surgical treatment in patients with lumbosacral spinal lipoma. Pre- and postoperative courses of 34 patients were retrospectively analyzed. The age at surgery ranged from 1 month to 47 years. The records of preoperative neurological status indicated that older patients had more severe deficits, while all 8 asymptomatic patients were under 5 years of age. Motor deficits were noted in 9 patients, in 7 of whom the lipoma extended cranially beyond the L5 level. Transitional-type lipomas were accompanied by more severe deficits (asymptomatic 1, symptomatic 17) than other types (asymptomatic 7, symptomatic 9). Postoperative follow-up periods ranged from 5 months to 13 years. During these periods, 7 of the 8 asymptomatic patients remained neurologically intact. Nine of the 26 symptomatic patients improved. Age, extension of the lipoma in the spinal canal and type of lipoma will influence the preoperative neurological status of the patients. Early untethering surgery is recommended in patients with large lipomas extending beyond the L5 level.

Key words Lumbosacral spinal lipoma Occult spinal dysraphism Surgical treatment Tethered cord 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2000

Authors and Affiliations

  • I. Koyanagi
    • 1
  • Y. Iwasaki
    • 2
  • K. Hida
    • 2
  • H. Abe
    • 2
  • T. Isu
    • 3
  • M. Akino
    • 4
  • T. Aida
    • 5
  1. 1.Hokkaido Neurosurgical Memorial Hospital, North 22, West 15, Chuo-ku, Sapporo, 060-0022 Japan Tel.: +81-11-7172131 Fax: +81-11-7172688JP
  2. 2.Department of Neurosurgery, Hokkaido University School of Medicine, Sapporo, JapanJP
  3. 3.Department of Neurosurgery, Kushiro Rousai Hospital, Kushiro, JapanJP
  4. 4.Sapporo Azabu Neurosurgical Hospital, Sapporo, JapanJP
  5. 5.Department of Neurosurgery, Hakodate Chuo Hospital, Hakodate, JapanJP

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