Congenital spinal lipoma : analyzing the perplexed nomenclature and our management

Abstract EN

Objectives: In this analysis, we will investigate the epidemiological features of spinal lipomas diagnosed at a single institution.

Methods: This study was carried out by reviewing retrospectively the: patient's admission records, neuroimaging, operation records, and outpatient files and biopsy results were used to collect the data from all consecutive patients treated in single referral center.

Patient data were extracted from the King Hussein Medical Center (KHMC) Primary Spinal Tumors electronic Database, between 2006 and 2016.

Results: Our cohort consisted of 33-females (55.93%) and 26-males (44.06%), mean age: 3.45 ± 1.74 years.

The congenital spinal lipomas were categorized into: 40-conus lipomas (17-terminal, 15-transitional, 8-dorsal) and 19-filum lipomas, including 11-patients who had lipomyelomeningocele.

The most common promoter for diagnosis was skin stigmas (46.26 %), followed by associated malformations (30.63 %), and symptoms (23.11 %).

Prophylactic surgery was undertaken in selected cases.

In the initially asymptomatic group, 6-patients (28.57%) had late neurological deterioration.

Of the 8-patients with asymptomatic conus lipomas, 3-cases (37.50%) developed sphincter dysfunction and motor problems at long-term follow-up.

In the symptomatic group, 67.50% improved, 20% remained unchanged, and 12.50 % had late neurological deterioration.

None of the 6-patients with symptomatic filum lipoma deteriorated postoperatively.

Postoperative complications developed in 9 patients (13.55 %): seven transient local problems, 2 definitive urological deterioration .

Conclusion: Despite the lack of knowledge regarding the precise natural history of lumbosacral lipoma, in these lesions, the chances of developing neurological deficits increase with increasing age at presentation.

Management of congenital spinal lipomas is challenging.

Surgery remains the standard treatment.

However, literature regarding the role of prophylactic surgery is scanty.