Spinal cord lipomas in children: surgical resection and outcome

Background: management of spinal lipomas is considered a challenging task for pediatric neurosurgeons. Study Design: A prospective, clinical study. Objectives: To assess the neurological outcomes after surgical resection lipomas. Patients and methods: The study was performed on 30 patients, underwent cord cases were followed up post-operatively in outpatient clinic at least 24 months. Results; This included patients with (12 boys 18 girls) age less than two years surgery. At presentation, all had low back swelling.19 (63.3%) bladder dysfunction, whom 14 (73.7%) incomplete while 5(26.3%) complete dysfunction. 16 (53.3%) motor weakness. Two (6.6%) presented by orthopedic deformities. All no previous surgery lipoma. Three types detected pre-operative magnetic resonance image (MRI); transitional (n = 24), dorsal 5), caudal 1). Excision lipoma near total 21(70%) subtotal 9 (30%) cases. Post-operative Complications; cerebro-spinal fluid (CSF) leakage 5 (16.6%) cases, wound infection 4 (13.3%).Early outcome: acquired new but transient deficit. Out who experienced weakness; 13 (81.3%) improved whereas 3 (18.7 %) got. Incomplete dysfunction regained (64.3%) only one patient (7.1%) progressed to have (out patients). None showed improvement. Long-term outcomes: weakness, 11 (68.7%) improved, (31.3%) developed worsening (p < 0.001). Concerning function; (81.9%) normal function maintained normal, noted 2 (18.1%) patients. remained CIC, 13(92.9%) case i.e. untethering resulted significant improvement deficits (motor urological), as p values 0.001. On long-term follow-up our five (16.7%) symptomatic re-tethering (neurological deterioration), partial excision mean time interval from appearance first symptom those 10 months (range, - months), did not improve it months) 0.001, indicating beneficial role early Conclusion: Better could be achieved near-total