Original Article

Subpial Spinal Lipoma without Dysraphism

Divye Prakash Tiwari, Vivek Sharma and Janak Raj
World Journal of Surgical Medical and Radiation Oncology 2013, 2:12

Abstract

Introduction

Subpial spinal lipoma without dysraphism is rare lesion and the management remains challanging. In our study we present the extensive clinico-radiological findings and optimum management protocol.

Methods

Fifteen patients who reported with nondysraphic spinal cord lipomas between March 2000 and April 2012 were retrospectively reviewed. All had varying degrees of neurological symptoms at the time of surgery with characteristic features on magnetic resonance imaging. All patients underwent decompression with a laminectomy/laminoplasty and duroplasty.

Results

The age at presentation ranged from 14 to 45 years (mean 28.8Yrs). Patients were followed-up for minimum of 6 months and maximum of 5 years. The most common location was dorsal spine while 4 vertebral segments involvement was found in 66.6% of cases. There was neurological improvement following surgery in all cases. Four patients had recurrence of symptoms.

Conclusion

Surgical excision of subpial lipomas is best treatment offered to the patients presenting with neurological deficits. The amount of surgical resection has not any influence on recovery from symptoms. Hence aggressive debulking should not be attempted as it may aggrevate neurological deficit. Thus adequate decompression with preservation of neural structures should be the aim of surgery.

Keywords

Intraspinal subdural lipomas, Intradural lipoma, Non-dysraphic lipoma, Spinal lipoma,

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