Late-Onset Non-Dysraphic Intradural Spinal Cord Lipoma: A Case Report and Literature Review

Here we report a case of late-onset non-dysraphic intradural spinal cord lipoma and provide a brief review of the literature. A 67-year-old man was referred to our department with a 6-month history of progressive gait ataxia. He had spastic paraparesis with left iliopsoas muscle weakness and hypoesthesia predominantly in the left leg. Magnetic resonance imaging (MRI) revealed an intradural extramedullary tumor suggestive of a lipoma at the T11-12 level. After laminectomy at T11-12 and resection of approximately 20-30% of the tumor according to intraoperative neuromonitoring findings, we performed duraplasty to decompress the spinal cord and posterior fusion (T11-L1) to prevent deterioration due to post-laminectomy kyphosis. The pathological diagnosis was lipoma. Gait ataxia and left paraparesis were improved at the 1-year follow up, and postoperative MRI demonstrated sufficient decompression of the affected spinal segments. Decompression with duraplasty, in addition to adequate tumor resection based on neuromonitoring findings, is an optimal treatment for non-dysraphic intradural spinal cord lipoma and is recommended to avoid postoperative neurological deterioration. Furthermore, posterior fusion can prevent deterioration due to post-laminectomy kyphosis and postoperative tethering. Central Sakai et al. (2014) Email: Ann Orthop Rheumatol 2(1): 1008 (2014) 2/4 such as spina bifida occulta. Magnetic resonance imaging (MRI) showed a non-dysraphic intradural extramedullary mass suggestive of a lipoma at the T11-12 level compressing the spinal cord anteriorly (Figure 1). Computed tomography-myelography revealed an intradural low-density lesion (Figure 2).