Long Term Outcome of Non-Dysraphic Intramedullary Spinal Cord Lipomas in Adults: Case Series and Review

Srinivasan, Uddanapalli Sreeramulu; Raghunathan, Natarajan; Radhi, Lawrence

Abstract

STUDY DESIGN: It is a case series involving clinical presentation, radiological findings, surgical technique and long term outcome of Non-dysraphic intramedullary spinal cord lipomas in adults along with the review of the literature. PURPOSE: The purpose of the study is to find out from our series as well as from literature what determines the long term outcome and how it can be improved in patients diagnosed to have intramedullary spinal cord lipomas. OVERVIEW OF LITERATURE: Non-dysraphic spinal intramedullary lipomas in adults are extremely rare. Majority of cases occur in children and in cervico-dorsal regions. Only eight cases of dorso-lumbar spinal lipomas without spinal dysraphism in adults have been reported in the English literature till 2013.
METHODS
Here we report our experience with three such cases in the dorsolumbar region and discuss the surgical technique and the long term outcome of such cases.
RESULTS
Review of literature and from our own cases we conclude that long term outcome after surgery is determined by the preoperative neurological status.
CONCLUSIONS
Earlier surgical intervention with preserved neurological status results in better outcome. Radical subtotal excision without producing iatrogenic postoperative neurological deficit should be the goal of the surgery and it stabilizes the disease process in the long run. When early clinico-radiological signs of recurrence develop, such patient's to be reoperated immediately to prevent them from developing a fixed neurological deficit.