Lipomes du filum terminal : à propos de 17 cas et revue de littérature

Abstract

Introduction Filum terminal lipomas are being identified with increasing frequency due to the use of modern imaging (MRI). It is a benign pathology when asymptomatic. Surgical untethering is the treatment. Its incidence is unknown, but it had been estimated to be approximately 0.1%. Surgical intervention in pediatric neurosurgery has increased during the last two decades. Tethered cord syndrome may be due to thickened and fatty structural elements within the filum terminal that render it appropriately tense preventing normal stretching and movement. Material and methods We study the clinical and imaging for 17 patients; this filum was associated to other pathologies in 41.17% of cases: diastematomyelia, lipomyelomeningocele, dermal sinus, myelomeningocele. Clinical findings were mainly the cutaneous stigmatas and the orthopedic deformities and less frequently urinary disorders 29.41% of patients were asymptomatic. All patients were explored with MRI. A medullary CT scan was performed in 58.82% of cases. Results All patients were operated between 2010 to 2016. Evolution was favorable in 8 cases, stabilisation in 7 and aggravation in 2 patients. Conclusion Filum terminal lipomas are a common incidental finding on lumber spinal. MRI surgery is the best option. Evolution after surgery is generally good.