Results after surgery for lumbosacral lipoma: the significance of early and late worsening

We retrospectively reviewed 32 patients operated on for lipoma of the conus and lipomyeloschisis, the two main anatomical subtypes of congenital lumbosacral lipomas associated with tethered cord syndrome. Surgery was proposed to patients when they were symptomatic, and in most cases for progressive...

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Bibliographic Details
Published in:Child's nervous system 1999-09, Vol.15 (9), p.439-442
Main Authors: Van Calenbergh, F, Vanvolsem, S, Verpoorten, C, Lagae, L, Casaer, P, Plets, C
Format: Article
Language:English
Subjects:
Adolescent
Adult
Elective Surgical Procedures
Female
Humans
Infant
Lipoma - complications
Lipoma - congenital
Lipoma - physiopathology
Lipoma - surgery
Lumbosacral Region
Male
Middle Aged
Neural Tube Defects - etiology
Neural Tube Defects - prevention & control
Retrospective Studies
Spina Bifida Occulta - prevention & control
Spinal Cord Neoplasms - complications
Spinal Cord Neoplasms - congenital
Spinal Cord Neoplasms - physiopathology
Spinal Cord Neoplasms - surgery
Time Factors
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Summary:We retrospectively reviewed 32 patients operated on for lipoma of the conus and lipomyeloschisis, the two main anatomical subtypes of congenital lumbosacral lipomas associated with tethered cord syndrome. Surgery was proposed to patients when they were symptomatic, and in most cases for progressive symptoms. The evolution of the different symptoms was studied separately. In most patients, symptoms improved or stabilized after surgery; in some, however, postoperative worsening, at least of some of the symptoms, was seen. This postoperative worsening became apparent either early or late after the operation, and was not associated with surgical trauma or postoperative complications. We suggest it was caused mainly by the natural course of the disease (especially in the case of the orthopedic deformities), and in some cases by retethering. Our series is not large enough to detect statistical significance for the different symptoms or for the anatomical subgroups. Importantly, according to our analysis by the different symptoms, the operation did not seem to protect the patients from later development of new deficits. This can be interpreted as an argument against prophylactic surgery in asymptomatic patients.
ISSN:0256-7040
1433-0350
DOI:10.1007/s003810050433