Vestigial Tail Associated to Spinal Lipomas: Report of Seven Cases

Abstract

Objective: Vestigial tail is a rare form of cutaneous stigmata often related to occult spinal dysraphism. We present 7 cases of vestigial tail associated to tethered cord and spinal lipomas in the Pediatric Neurosurgery Service of the Hospital Civil de Guadalajara. Methods: In this retrospective study from 2017-2022 we reviewed the spinal dysraphism data base of the Hospital de Guadalajara and included the cases of vestigial tails. Results: 7 patients, 5 female and 2 males with vestigial tails were included. Six different morphologies of tails are described so as their location and relationship to occult spinal dysraphism. All the patients received surgical treatment. Complete resection of the cutaneous stigmata and cord detethering were performed in four cases related to fatty filum terminale and the remaining three of the patients required radical resection of associated complex conus medullaris lipomas. All the surgical procedures were performed with microsurgical techniques and neurophysiological monitoring. Conclusions: The different classifications include two main forms of tails, true tail and false tail. Most true tails represent only a cosmetic issue, while the false ones are often in close relationship with spinal dysraphism. Considering the risk of underlying malformations associated with false human tails, the preoperative assessment should include a thorough neurological examination, and a spine magnetic resonance imaging. We present the association of several forms of spinal lipomas related to vestigial tails. Keywords: Vestigial tail, Tethered cord, Spinal lipoma, Pseudo tail, Occult spinal dysraphism.