Intradural Spinal Lipoma Research Articles

Intradural spinal lipomas. Review of the literature (99 cases) and report of an additional case.

One hundred intradural spinal lipomas from the literature, including one of our own, are reviewed. Data about their sex and age incidence, location, pathology, aetiologic aspects, clinical course and clinical picture are reported. The roentgenographic and cerebrospinal fluid findings, the surgical treatment and the immediate and late operative results are discussed.

INTRADURAL LIPOMAS IN CHILDREN

A series of nine cases of intradural spinal lipomas presenting in childhood or infancy are discussed. In all instances, associated congenital defects and a history of insidious neurological deficit were characteristic findings. In seven of the nine cases a subtotal removal of the intradural lipoma was accomplished, with resulting improvement in the neurological condition. In all instances the pathological interpretation of the lesion was that of an adult type of lipoma. Despite the benign connotations of lipoma, total surgical removal of these lipomas occurring intradurally has often been found not feasible and is probably not necessary. The inclusion of lipoma tissue within the substance of the spinal cord and nerve roots renders manipulation and excision extremely hazardous in terms of retaining the integrity of the nervous structures involved. In these instances subtotal surgical removal and decompression have proven beneficial in all instances in this series. Although exaggeration of neurological deficit may occur postoperatively, if the above surgical principles are adhered to, this deficit is not necessarily of a permanent nature.

INTRADURAL SPINAL LIPOMA

Lipoma of the spinal cord unassociated with spina bifida, extradural or intradural, is rare. In a review of the literature up to 1926, reports of only nine extradural and nine intradural lipomas have been found. Their rarity is further indicated by the fact that of 35,000 necropsies reviewed by Schlesinger, 1 6,540 showed some form of tumor, but no intradural spinal lipoma was found. In the statistics of the New York Neurological Institute, no instance of either extradural or intradural lipoma unassociated with spina bifida was found at either necropsy or operation. Schlesinger's review of the literature brought forth reports of three intradural and twelve extradural lipomas. Spiller, in 1899, reported a case of a minute intradural lipoma in the filum terminale and verified the cases reviewed by Schlesinger without finding a single additional one. He was unable to find one reference (Holmes, 1885) cited by Schlesinger, nor have I