Commentary to the article: asymptomatic lumbosacral lipomas—a natural history study, by Wykes V, Desai D, and Thompson DNP

Excerpt

This paper describes a retrospective study of the natural history of unoperated asymptomatic spinal cord lipomas followed for 10 years at Great Ormond Street Hospital in London. The only other such study came out of L’hôpital Necker-Enfants Malades in Paris in 2004 [1]. The two studies are comparable in structure (56 children, 0–10 years of age from London versus 53 similar aged children from Paris; follow-up period was 10 years in London versus 9 years in Paris), and the results are similar. The London group found a deterioration rate of 40 % over 10 years, whilst the Parisian group showed a 34 % deterioration over 9 years. There are just two major dissimilarities: the Parisian study is prospective whereas the London one is retrospective, and filum lipomas are included in the Paris series but not in the London’s. So I think the primary message from both studies about asymptomatic lipomas is believable, that there is at least a 35–40 % natural progression rate of neurological deficits in spinal cord lipomas without surgical treatment. …