Research Article
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Surgical Treatment of Lumbosacral Lipomas: Our Clinical Experience

Year 2022, Volume: 48 Issue: 1, 49 - 52, 01.04.2022

Duygu Baykal Ali İmran Özmarasalı M Özgür Taşkapılıoğlu

https://doi.org/10.32708/uutfd.1032701

Abstract

Spinal cord lipomas are among the most challenging lesions in the field of pediatric neurosurgery. The natural course and treatment of spinal lipomas are controversial. In this study, we aimed to evaluate the clinical, demographic data and treatment results of patients who were operated on in our clinic for spinal cord lipoma. The data of 59 patients were evaluated retrospectively. The mean age of the patients was 10±5.8 (1-25) months, and the most common complaint was swelling in the lumbar region. While 36 of our patients had neurological deficit at the time of admission, 23 had no neurological deficit. No neurological deterioration was observed in the postoperative period. The patients were followed up for a mean of 39.9± 32.9 (1-132) months. Thirteen (22%) cases were re-operated due to neurological deterioration in the follow-up. Even if they are asymptomatic, surgical intervention at the appropriate time can prevent neurological deterioration that may develop in children with these lesions. Multicenter prospective studies will enable us to reach more rational information on this subject.

Keywords

spinal lipoma spinal dysraphism tethered cord

References

  • 1. Blount JP, Elton S. Spinal lipomas. Neurosurg Focus 2001; 10(1): E3.
  • 2. Hirsch JF, Pierre-Kahn A. Lumbosacral lipomas with spina bifida. Childs Nerv Syst. 1988; 4(6): 354-60.
  • 3. La Marca F, Grant JA, Tomita T, McLone DG. Spinal lipomas in children: Outcome of 270 procedures. Pediatr Neurosurg 1997; 26: 8-16.
  • 4. Osborn AG. Normal anatomy and congenital anomalies of the spine and spinal cord. In Osborn AG (ed), Diagnostic Neuroradiology. 1st edition. St Louis: Mosby, 1994: 785-819
  • 5. Spiller WG. Congenital and acquired enuresis from spinal lesion: a) myelodysplasia, b) stretching of the cauda equina. Am J Med Sci 1916; 151:469–75.
  • 6. Lassman LP, James CCM. Lumbosacral lipomas: critical survey of 26 cases submitted to laminectomy. J Neurol Neurosurg Psychiatry 1967; 30:174–81.
  • 7. Jones PH, Love JG. Tight filum terminale. Arch Surg 1956; 73:556–66.
  • 8. Morioka T, Murakami N, Shimogawa T, et al. Neurosurgical management and pathology of lumbosacral lipomas with tethered cord. Neuropathology. 2017;37:385-392.
  • 9. Morimoto K, Takemoto O, Wakayama A. Spinal lipomas in children--surgical management and long-term follow-up. Pediatr Neurosurg. 2005;41:84-7
  • 10. Usami K, Lallemant P, Roujeau T, et al. Spinal lipoma of the filum terminale: review of 174 consecutive patients Childs Nerv Syst. 2016;32:1265-72
  • 11. Cochrane DD. Cord untethering for lipomyelomeningocele: Expectation after surgery. Neurosurg Focus 2007; 23(2): E9.
  • 12. Cochrane DD, Finley C, Kestle J, Steinbok P. The patterns of late deterioration in patients with transitional lipomyelomeningocele. Eur J Pediatr Surg 2000; 1: 13-7
  • 13. Huang SL, Shi W, Zhang LG. Surgical treatment for lipomyelomeningocele in children. World J Pediatr 2010; 6: 361-65.
  • 14. Xenos C, Sgouros S, Walsh R, Hockley A. Spinal lipomas in children. Pediatr Neurosurg 2000; 32: 295-307
  • 15. Selçuki M. Spinal orta hat birleşim anomalileri. In: Korfalı E, Zileli, M (eds), Temel Nöroşirürji, ikinci baskı. Ankara: Türk Nöroşirürji Derneği, 2010: 1883-97
  • 16. Byrne RW, Hayes EA, George TM, McLone DG. Operative resection of 100 spinal lipomas in infants less than 1 year of age. Pediatr Neurosurg 1995; 23: 182-86.
  • 17. Pierre-Kahn A, Lacombe J, Pichon J, et al. Intraspinal lipomas with spina bifida. Prognosis and treatment in 73 cases. J Neurosurg 1986; 65: 756-61.
  • 18. Pierre-Kahn A, Zerah M, Renier D, et al. Congenital lumbosacral lipomas. Childs Nerv Syst 1997; 13: 298-334.
  • 19. Wykes V, Desai D, Thompson DN. Asymptomatic lumbosacral lipomas: A natural history study. Childs Nerv Syst 2012; 28: 1731-39.
  • 20. Van Calenbergh F, Vanvolsem S, Verpoorten C, et al. Results after surgery for lumbosacral lipoma: The significance of early and late worsening. Childs Nerv Syst 1999; 15:439-42.
  • 21. Arai H, Sato K, Okuda O, et al. Surgical experience of 120 patients with lumbosacral lipomas. Acta Neurochir (Wien) 2001; 143: 857-64.
  • 22. Colak A, Pollack IF, Albright AL. Recurrent tethering: a common long-term problem after lipomyelomeningocele repair. Pediatr Neurosurg 1998; 29:184-90.
  • 23. Kanev PM, Lemire RJ, Loeser JD, Berger MS. Management and long-term follow-up review of children with lipomyelomeningocele, 1952-1987. Journal of neurosurgery. 1990;73:48–52.

Lumbosakral Lipomların Cerrahi Tedavisi- Klinik Deneyimimiz

Year 2022, Volume: 48 Issue: 1, 49 - 52, 01.04.2022

Duygu Baykal Ali İmran Özmarasalı M Özgür Taşkapılıoğlu

https://doi.org/10.32708/uutfd.1032701

Abstract

Spinal kord lipomları, pediatrik beyin cerrahisi alanının en zorlayıcı lezyonları arasındadır. Spinal lipomların doğal seyirleri ve tedavileri tartışmalıdır. Bu çalışmada spinal kord lipomu nedeni ile kliniğimizde opere edilen hastaların klinik, demografik verileri ve tedavi sonuçlarının değerlendirilmesi amaçlanmıştır. Elli dokuz hastanın verileri retrospektif olarak değerlendirilmiştir. Hastaların yaş ortalaması 10±5,8 (1-25) ay, en sık başvuru şikayeti bel bölgesindeki şişlik idi. Hastalarımızın başvuru anında 36’sında nörolojik defisit varken 23’ünde nörolojik defisit yoktu. Olgularda postopertif dönemde nörolojik kötüleşme izlenmedi. Hastalar ortalama 39,9± 32,9 (1-132) ay takip edildi. 13 (%22) olgu takiplerinde nörolojik kötüleşme olması nedeni ile yeniden opere edildi. Asemptomatik olsalar dahi uygun zamanda uygulanan cerrahi müdahale, bu lezyonlara sahip çocuklarda gelişebilecek nörolojik bozulmayı önleyebilir. Çok merkezli prospektif çalışmalar bu konu hakkında daha rasyonel bilgilere ulaşmamızı sağlayacaktır.

Keywords

Spinal lipom spinal disrafizm gergin omurilik

References

  • 1. Blount JP, Elton S. Spinal lipomas. Neurosurg Focus 2001; 10(1): E3.
  • 2. Hirsch JF, Pierre-Kahn A. Lumbosacral lipomas with spina bifida. Childs Nerv Syst. 1988; 4(6): 354-60.
  • 3. La Marca F, Grant JA, Tomita T, McLone DG. Spinal lipomas in children: Outcome of 270 procedures. Pediatr Neurosurg 1997; 26: 8-16.
  • 4. Osborn AG. Normal anatomy and congenital anomalies of the spine and spinal cord. In Osborn AG (ed), Diagnostic Neuroradiology. 1st edition. St Louis: Mosby, 1994: 785-819
  • 5. Spiller WG. Congenital and acquired enuresis from spinal lesion: a) myelodysplasia, b) stretching of the cauda equina. Am J Med Sci 1916; 151:469–75.
  • 6. Lassman LP, James CCM. Lumbosacral lipomas: critical survey of 26 cases submitted to laminectomy. J Neurol Neurosurg Psychiatry 1967; 30:174–81.
  • 7. Jones PH, Love JG. Tight filum terminale. Arch Surg 1956; 73:556–66.
  • 8. Morioka T, Murakami N, Shimogawa T, et al. Neurosurgical management and pathology of lumbosacral lipomas with tethered cord. Neuropathology. 2017;37:385-392.
  • 9. Morimoto K, Takemoto O, Wakayama A. Spinal lipomas in children--surgical management and long-term follow-up. Pediatr Neurosurg. 2005;41:84-7
  • 10. Usami K, Lallemant P, Roujeau T, et al. Spinal lipoma of the filum terminale: review of 174 consecutive patients Childs Nerv Syst. 2016;32:1265-72
  • 11. Cochrane DD. Cord untethering for lipomyelomeningocele: Expectation after surgery. Neurosurg Focus 2007; 23(2): E9.
  • 12. Cochrane DD, Finley C, Kestle J, Steinbok P. The patterns of late deterioration in patients with transitional lipomyelomeningocele. Eur J Pediatr Surg 2000; 1: 13-7
  • 13. Huang SL, Shi W, Zhang LG. Surgical treatment for lipomyelomeningocele in children. World J Pediatr 2010; 6: 361-65.
  • 14. Xenos C, Sgouros S, Walsh R, Hockley A. Spinal lipomas in children. Pediatr Neurosurg 2000; 32: 295-307
  • 15. Selçuki M. Spinal orta hat birleşim anomalileri. In: Korfalı E, Zileli, M (eds), Temel Nöroşirürji, ikinci baskı. Ankara: Türk Nöroşirürji Derneği, 2010: 1883-97
  • 16. Byrne RW, Hayes EA, George TM, McLone DG. Operative resection of 100 spinal lipomas in infants less than 1 year of age. Pediatr Neurosurg 1995; 23: 182-86.
  • 17. Pierre-Kahn A, Lacombe J, Pichon J, et al. Intraspinal lipomas with spina bifida. Prognosis and treatment in 73 cases. J Neurosurg 1986; 65: 756-61.
  • 18. Pierre-Kahn A, Zerah M, Renier D, et al. Congenital lumbosacral lipomas. Childs Nerv Syst 1997; 13: 298-334.
  • 19. Wykes V, Desai D, Thompson DN. Asymptomatic lumbosacral lipomas: A natural history study. Childs Nerv Syst 2012; 28: 1731-39.
  • 20. Van Calenbergh F, Vanvolsem S, Verpoorten C, et al. Results after surgery for lumbosacral lipoma: The significance of early and late worsening. Childs Nerv Syst 1999; 15:439-42.
  • 21. Arai H, Sato K, Okuda O, et al. Surgical experience of 120 patients with lumbosacral lipomas. Acta Neurochir (Wien) 2001; 143: 857-64.
  • 22. Colak A, Pollack IF, Albright AL. Recurrent tethering: a common long-term problem after lipomyelomeningocele repair. Pediatr Neurosurg 1998; 29:184-90.
  • 23. Kanev PM, Lemire RJ, Loeser JD, Berger MS. Management and long-term follow-up review of children with lipomyelomeningocele, 1952-1987. Journal of neurosurgery. 1990;73:48–52.
There are 23 citations in total.

Details

Primary Language Turkish
Subjects Surgery
Journal Section Research Article
Authors

Duygu Baykal 0000-0003-3185-3172

Ali İmran Özmarasalı 0000-0002-7529-2808

M Özgür Taşkapılıoğlu 0000-0001-5472-9065

Publication Date April 1, 2022
Acceptance Date March 25, 2022
Published in Issue Year 2022 Volume: 48 Issue: 1

Cite

APA Baykal, D., Özmarasalı, A. İ., & Taşkapılıoğlu, M. Ö. (2022). Lumbosakral Lipomların Cerrahi Tedavisi- Klinik Deneyimimiz. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 48(1), 49-52. https://doi.org/10.32708/uutfd.1032701
AMA Baykal D, Özmarasalı Aİ, Taşkapılıoğlu MÖ. Lumbosakral Lipomların Cerrahi Tedavisi- Klinik Deneyimimiz. Uludağ Tıp Derg. April 2022;48(1):49-52. doi:10.32708/uutfd.1032701
Chicago Baykal, Duygu, Ali İmran Özmarasalı, and M Özgür Taşkapılıoğlu. “Lumbosakral Lipomların Cerrahi Tedavisi- Klinik Deneyimimiz”. Uludağ Üniversitesi Tıp Fakültesi Dergisi 48, no. 1 (April 2022): 49-52. https://doi.org/10.32708/uutfd.1032701.
EndNote Baykal D, Özmarasalı Aİ, Taşkapılıoğlu MÖ (April 1, 2022) Lumbosakral Lipomların Cerrahi Tedavisi- Klinik Deneyimimiz. Uludağ Üniversitesi Tıp Fakültesi Dergisi 48 1 49–52.
IEEE D. Baykal, A. İ. Özmarasalı, and M. Ö. Taşkapılıoğlu, “Lumbosakral Lipomların Cerrahi Tedavisi- Klinik Deneyimimiz”, Uludağ Tıp Derg, vol. 48, no. 1, pp. 49–52, 2022, doi: 10.32708/uutfd.1032701.
ISNAD Baykal, Duygu et al. “Lumbosakral Lipomların Cerrahi Tedavisi- Klinik Deneyimimiz”. Uludağ Üniversitesi Tıp Fakültesi Dergisi 48/1 (April 2022), 49-52. https://doi.org/10.32708/uutfd.1032701.
JAMA Baykal D, Özmarasalı Aİ, Taşkapılıoğlu MÖ. Lumbosakral Lipomların Cerrahi Tedavisi- Klinik Deneyimimiz. Uludağ Tıp Derg. 2022;48:49–52.
MLA Baykal, Duygu et al. “Lumbosakral Lipomların Cerrahi Tedavisi- Klinik Deneyimimiz”. Uludağ Üniversitesi Tıp Fakültesi Dergisi, vol. 48, no. 1, 2022, pp. 49-52, doi:10.32708/uutfd.1032701.
Vancouver Baykal D, Özmarasalı Aİ, Taşkapılıoğlu MÖ. Lumbosakral Lipomların Cerrahi Tedavisi- Klinik Deneyimimiz. Uludağ Tıp Derg. 2022;48(1):49-52.
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