Surgery for Spinal Lipoma of the Conus Medullaris

Abstract

Lipoma of the conus medullaris(LCM)can cause neurological symptoms known as tethered cord syndrome(TCS). The symptoms can be seen at diagnosis and during long-term follow-up. Even after surgical treatment, some patients can present with neurological deterioration indicating a TCS, defined as retethered cord syndrome(ReTCS). In this report the surgical technique for conus lipoma comprising wide osteoplastic laminotomy with confirmed whole spinal lipoma and adjacent normal spinal tissue is described, with dissection performed from the proximal side to the distal side with confirmed normal spinal cord and roots under operative microscope, expansive dural plasty aiming to get low cord/sac ratio was reported. Considering that some patients with LCM show postoperative neurological symptoms due to TCS in a long-term follow-up period, careful postoperative follow-up is necessary.