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Minimally Invasive Surgical Strategy to Filum Lipoma.
Neurol Med Chir (Tokyo). 2018 Jan 23;:
Authors: Hayashi T, Kimiwada T, Kohama M, Shirane R, Tominaga T
Summary
Filum terminale lipoma (FTL) causes varied spinal signs often called tethered wire syndrome. The therapy for FTL is surgical untethering by sectioning the FTL, which may stop symptom development and infrequently leads to enchancment of signs. This report describes a minimally invasive surgical technique that we’ve got launched for FTL sectioning. The pediatric sufferers with FTL since 2007 had been handled utilizing this minimally invasive surgical technique, which we discuss with as an interlaminar method (ILA). In abstract, the surgical method entails: minimal pores and skin incision to reveal the unilateral ligamentum flavum within the decrease lumbar area; ligamentum flavum incision to reveal the dural sac, and dural incision adopted by identification and sectioning of the filum. Postoperatively, no mattress relaxation was required. Previous to introducing ILA, we had used customary one stage laminectomy/laminotomy (LL) with greater than 1 week of postsurgical mattress relaxation till 2007, offering an enough management group for the advantage of the ILA. A complete of 49 consecutive sufferers had been handled utilizing ILA. Whereas 37 sufferers had been handled utilizing LL. Surgical issues that want surgical procedure had been seen solely in a single affected person, who developed cerebrospinal fluid (CSF) leak in LL sufferers. No retethering or further neurological signs had been seen throughout follow-up. All sufferers complained of minimal postsurgical again ache, however no sufferers required postoperative mattress relaxation in ILA sufferers, whereas LL sufferers want postsurgical mattress relaxation due to again ache. The ILA technique offers the benefit of a minimal tissue damage, related to minimal postoperative ache, blood loss, and mattress relaxation.
PMID: 29367470 [PubMed – as supplied by publisher]