Lipoma and Occult Spinal Dysraphism
Keywords:
Lipoma, Meningomyelocele, Spina Bifida Occulta, Spinal Cord, Spinal DysraphismAbstract
Congenital abnormality, an occult spinal dysraphism with spinal lipoma, is a rare dysraphic spinal abnormality. The syndrome, treatments, outcomes, and current controversies are reviewed.
Occult spinal dysraphism usually is usually manifested without clinical changes, either neurological or local changes. Local cutaneous changes associated with occult spinal dysraphism include midline lumbosacral hypertrichosis, lumbosacral cutaneous hemangiomas, lumbosacral dermal sinus and midline lumbosacral subcutaneous lipoma. Neurological changes in spina bifida occulta and spinal lipoma include local and radicular pain, asymmetric hyporeflexia, spasticity, sensory changes, weakness and bowel/bladder dysfunction. A progressive neurological/urological dysfunction limited to the conus medullaris may also suggest other spinal cord syndromes. Ultrasonography, CT scanning, MR imaging, and plain radiography assist with the localization of the conus medullaris level changes but also the identification of the specific spinal elements affected. Surgical intervention for the asymptomatic lipoma of the conus medullaris has been an area of controversy, primarily due to the paucity of studies in which the natural history of this disorder is researched in detail. Excising cutaneous changes is recommended in case of any esthetic or functional disturbances.
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