The article discusses the clinical presentation, surgical management, and postoperative outcomes of nondysraphic intramedullary spinal cord lipomas (NDSCL) in children. NDSCL is a rare type of spinal cord tumor that accounts for 1% of cases, and its clinical presentation is unspecific. The study reports on three cases of NDSCL in children, all of whom had neurological deterioration, pain, spinal rigidity, and in two cases, a subcutaneous mass. The lipomas were located in the cervico-thoracic or lumbar regions and were massive, requiring decompression surgery. The surgical approach involved partial resection with or without dural plasty and laminoplasty. The postoperative outcomes were favorable, with no recurrence of symptoms or spinal deformities. The study highlights the need to be attentive to the risk of spinal deformity in these young patients
Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best recognised day surgery spinal centre in London
Published article
CONCLUSION: NDSCL is a rare entity which often manifests with progressive pain and neurological deficits. In our experience, partial resection with or without dural plasty and laminoplasty has been associated with satisfactory postoperative outcomes and no recurrence of symptoms. We should be attentive to the risk of postoperative spinal deformity in these young patients.
Lumbar Decompression Surgery Expert. Best Spinal Surgeon UK
Neurochirurgie. 2023 Jul 21:101473. doi: 10.1016/j.neuchi.2023.101473. Online ahead of print.ABSTRACTBACKGROUND AND PURPOSE: Nondysraphic intramedullary spinal cord lipomas (NDSCL) represent 1% of spinal cord tumors. They are less frequent than dysraphic spinal cord lipomas and clinical presentation is unspecific. There are no guidelines on surgical management.MATERIAL AND METHODS: We report three observations of NDSCL in children,
Neurochirurgie. 2023 Jul 21:101473. doi: 10.1016/j.neuchi.2023.101473. Online ahead of print.
ABSTRACT
BACKGROUND AND PURPOSE: Nondysraphic intramedullary spinal cord lipomas (NDSCL) represent 1% of spinal cord tumors. They are less frequent than dysraphic spinal cord lipomas and clinical presentation is unspecific. There are no guidelines on surgical management.
MATERIAL AND METHODS: We report three observations of NDSCL in children, focusing on the clinical presentation, surgical management and postoperative outcome.
RESULTS: The patients, one female and two males, aged from 5 months to 10 years presented with neurological deterioration, pain, spinal rigidity and in two cases, a subcutaneous mass. Spinal MRI found intradural lipomas without spina bifida, located in the cervico-thoracic area in all cases. The lipoma extended to the medulla oblongata in two cases and was in the lumbar region in the third. These lipomas were massive, requiring decompression surgery. Surgery confirmed the lipoma to be subpial. We performed debulking of the lipoma without attempting total resection, and with or without dural plasty and laminoplasty, followed by minerva cast in two cases, and avoidance of standing in the youngest. Satisfactory recovery occurred in all three cases. After a follow-up between 4 months and 9 years, the outcome was favorable in all cases, and no patient presented with secondary spinal deformation or lipoma progression.
CONCLUSION: NDSCL is a rare entity which often manifests with progressive pain and neurological deficits. In our experience, partial resection with or without dural plasty and laminoplasty has been associated with satisfactory postoperative outcomes and no recurrence of symptoms. We should be attentive to the risk of postoperative spinal deformity in these young patients.
PMID:37482183 | DOI:10.1016/j.neuchi.2023.101473
The London Spine Unit : best recognised day surgery spinal centre in London
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Nondysraphic intramedullary spinal cord lipoma of the child: report of 3 cases
