Turkish Neurosurgery
Preventive surgery for asymptomatic spinal lipomas in children
Ding Gao1, Nan Bao1, Bo Yang1, YunHai Song1, ShouQing Sun1
1Shanghai Children’s Medical Center,School of Medicine,Shanghai Jiaotong University, Neurosurgery, Shanghai,
DOI: 10.5137/1019-5149.JTN.31209-20.2

Aim: To explore the clinical effect and significance of preventive surgery of asymptomatic spinal lipo-mas in children.Material and Methods:We retrospective analysis of clinical data of 168 cases with asymptomatic spinal lipoma from April 2001 to June 2019 in our hospital. The patients were aged from 1.5 months to 15 years (the average age was 7 months), and there were no neurological symptoms such as pain, incontinence, and / or bilateral lower limb dysfunction before surgery. The surgical proce-dure included: completely removed the lipomas in subcutaneous and extramedullary tissues of the spinal cord, subtotal resection of intraspinal fat, cutting and separating the spinal cord including the medullary cones from the dura sac to release the tethered cord.Results:For the 168 children with spinal lipomas included in the study, complete resection was undertaken for the dorsal spinal lipomas , subtotal resection was taken for the transitional and chaotic spinal lipomas .Subcutaneous effusion caused by cerebrospinal fluid leakage occurred in 5 cases after surgery, which was cured after multiple puncture and aspiration. Six patients developed mild in-continence immediately after the operation, 5 of whom completely returned to normal within 1 month, and 1 had no relief of symptoms.159 of the 168 patients were followed up for 3 to 19 years (the median follow-up time was 76 months). Long-term postoperative symptoms occurred in 13 patients (7.7%), including 12 cases of spinal cord retethering and 1 case of lipoma enlargement. Conclusion:Preventive surgery can reduce the incidence of neurological dysfunction in children with asymp-tomatic spinal lipomas in the future.

Corresponding author : Nan Bao