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Child's Nervous System

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16-12-2023 | Lipoma | Research

Spinal cord lipomas: lessons learned in the era of total resection

Authors: Julia Casado-Ruiz, Bienvenido Ros, Sara Iglesias, Angela Ros, MA Arráez

Published in: Child's Nervous System | Issue 4/2024

Abstract

Purpose

Recent years have seen a paradigm shift towards total/near-total resection in spinal cord lipoma surgery. As this procedure is technically challenging, surgical candidates need to be selected appropriately through accurate image assessment and classification. The purpose of this paper is to describe a surgical series of paediatric spinal cord lipomas, their diagnosis, results and complications.

Methods

We undertook a retrospective review of paediatric patients with spinal cord lipomas who underwent surgery between 2008 and 2022. The variables studied were age, gender, preoperative symptoms according to the Necker Functional Score (NFS), type of lipoma according to Morota’s classification, functional and radiological surgical outcomes using the cord-sac ratio (CSR), need for re-operation, complications and follow-up.

Results

A total of 25 patients (average age 36 months) underwent surgery. According to Morota’s classification, MRI showed 13 type 1 lipomas, two type 2, two type 3 and eight type 4. The preoperative NFS was 16.06, with urological abnormalities being the most frequent manifestation. Total/near-total resection was attempted since 2015. Five patients with type 1 lipoma required re-operation due to clinical deterioration with suspected retethering, all of them with a CSR > 0.3. The series average CSR was 0.417.

Conclusions

This paper highlights the importance of proper classification for a correct surgical approach to obtain favourable results and minimise possible complications. Based on our experience, given our results regarding the percentage of fistulae and retethering rates, we limited radical resection to symptomatic type 1 lipomas. Our future aim is to obtain better CSR rates and to decrease the retethering percentage.

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Title: Spinal cord lipomas: lessons learned in the era of total resection
Authors: Julia Casado-Ruiz
Bienvenido Ros
Sara Iglesias
Angela Ros
MA Arráez
Publication date: 16-12-2023
Publisher: Springer Berlin Heidelberg
Keywords: Lipoma
Lipoma
Published in: Child's Nervous System / Issue 4/2024
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-023-06251-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Spinal cord lipomas: lessons learned in the era of total resection

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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