Transition from partial to near-total/radical resection of spinal cord lipomas.

Abstract

The objective of this retrospective study was to compare the outcomes and associated complication rates in the surgical management of spinal cord lipomas following a change of practice within our institution from partial resection (PR) to near-total/radical resection (NTR). Twenty-four children underwent surgical treatment for symptomatic spinal cord lipomas between 2009 and 2020. The near-total/radical resection group included 20patients with spinal cord lipomas and the comparison group included 6 patients with spinal cord lipomas who underwent partial resection. Filar lipomas were excluded. The mean age of the patients was 7years (range 1-14years). Post-operatively, a higher proportion of NTR patients (17/20, 85%) demonstrated improvement or stabilisation in Necker-Enfants Malades scores compared to PR patients (3/6, 50%) with a mean follow-up of 48 and 108months respectively. Two patients underwent re-do untethering surgery, both of which initially underwent partial resection surgery. Complication rates did not significantly differ between the two groups. Our data supports the view that near-total/radical resection should be considered the technique of choice over the conventional method of partial resection for spinal cord lipomas with no significant increase in complication rates.