Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Lumbosacral lipomas with spina bifida

  • 51 Accesses

  • 22 Citations


The pathological and metabolic characteristics, as well as the anatomical and functional evolution of lumbosacral lipomas, were studied in a series of 73 patients operated on between 1970 and 1983. The pathological study showed that they are mainly composed of adipocytes, but that they also possess fibrous tissue, vessels, and nerve fibers. Innervated muscle fibers, contracting under proper nerve stimulation, were found in several cases. Lipogenesis and lipolysis are the same in lumbosacral lipomas and in normal fat tissue. However, these lipomas can grow with the rest of the fatty pool. Moreover, spontaneous progressive worsening of the clinical status has been observed in 36% of the cases. Surgery is efficient and not harmful to the patient. Postoperative mortality was nil. Early postoperative worsening occurred in 2.7% of the cases. The 6% rate of late postsurgical deteriorations should be compared to the 36% to 56% rate found when patients are not operated on. Three different mechanisms are responsible for clinical worsening: compression or stretching of the cord, and cord injury on the posterior upper limit of the spinal defect. In each case, one mechanism is prevalent. Three different types of lumbosacral lipomas can thus be individualized. The surgical implications of these data are discussed. The necessity for early and systematic surgical treatment is pointed out.

This is a preview of subscription content, log in to check access.


  1. 1.

    Anderson FM (1975) Occult spinal dysraphism: a series of 73 cases Pediatrics. 55:826–835

  2. 2.

    Basset RC (1950) The neurological deficit associated with lipomas of the cauda equina. Ann Surg 13:109–116

  3. 3.

    Bruce DA, Schut L (1979) Spinal lipomas in infancy and childhood. Child's Brain 5:192–203

  4. 4.

    Chapman PH (1982) Congenital intraspinal lipomas. Anatomic considerations and surgical treatment. Child's Brain 9:37–47

  5. 5.

    Ehni G, Grafton Love J (1945) Intraspinal lipomas. Report of cases; review of the literature and clinical and pathologic study. Arch Neurol Psychiatry 53:1–28

  6. 6.

    French BN (1982) The embryology of spinal dysraphism. Spinal dysraphism — clinical neurosurgery. Proceedings of the Congress of Neurological Surgeons, Toronto, vol 30. Canada, Williams and Wilkins, Baltimore London, pp 295–340

  7. 7.

    Giuffre R (1966) Intradural spinal lipomas. Review of the literature (99 cases) and report of an additional case. Acta Neurochirurg 14:9–95

  8. 8.

    Hoffman HJ, Taecholarn C, Hendrick EB, Humphrey RP (1985) Management of lipomyelomeningoceles. Experience at the Hospital for Sick Children, Toronto, Canada. J Neurosurg 62:1–8

  9. 9.

    Ingraham FD, Swan H, Hamlin H, Lowrey JJ, Matson D, Scott HW (1943) Spina bifida and cranium bididum. Cambridge, Mass

  10. 10.

    James CCM, Lassman LP (1981) Spinal bifida occulta. Grune and Stratton, New York, pp 1–230

  11. 11.

    Johnson A (1857) Fatty tumour from the sacrum of a child connected with the spinal membranes. Trans Pathol Soc Lond 8:16–18

  12. 12.

    Lassman LP, James CCM (1967) Lumbosacral lipomas: critical survey of twenty-six cases submitted to laminectomy. J Neurol Neurosurg Psychiatry 30:174–181

  13. 13.

    Lemire RJ, Loeser JD, Leech RW, Alvord EG (1975) Normal and abnormal development of the human nervous system. Harper and Row, Hagerstown, Maryland, pp 71–83

  14. 14.

    McLone DG, Mutluer S, Naidich TP (1983) Lipomeningoceles of the conus medullaris. In: Raimondi J (ed) Concepts in pediatric neurosurgery. Karger, Basel, pp 170–177

  15. 15.

    McLone DG, Naidich TP (1985) Spinal dysraphism: experimental and clinical. The tethered spinal cord. Thieme-Stratton, New York, pp 14–28

  16. 16.

    Marin-Padilla M (1985) The tethered cord syndrome: developmental considerations. The tethered spinal cord. Thieme-Stratton, New York, pp 3–13

  17. 17.

    Pierre-Kahn A, Renier D, Sainte-Rose C, Hirsch JF (1982) Les lipomes lombo sacrés avec spina bifida — Correlations anatomo-cliniques — Résultats thérapeutiques. Neurochirurgie 29:359–363

  18. 18.

    Petit H, Jomin M, Julliot JP, Caron JC, Warot P (1979) Dysraphie lombo-sacrée et “moelle longue” de révélation tardive (9 observations). Rev Neurol 135:427–438

  19. 19.

    Renier D (1974) Les spina bidifa lombo-sacrés avec tumeur (étude de 36 cas opéres). Thèse de Médecine, Faculté Paris Ouest

  20. 20.

    Till K (1968) Spinal dysraphism, a study of congenital malformations of the back. Dev Med Child Neurol 10:470–477

  21. 21.

    Villarejo FJ, Blazquez MG, Gutierrez-Diaz JA (1976) Intraspinal lipomas in children. Child's Brain 2:361–370

  22. 22.

    Yamada S, Zinke DE, Delman Sanders A (1981) Pathophysiology of “tethered cord syndrome.” J Neurosurg 54:494–503

Download references

Author information

Correspondence to J. F. Hirsch.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Hirsch, J.F., Pierre-Kahn, A. Lumbosacral lipomas with spina bifida. Child's Nerv Syst 4, 354–360 (1988). https://doi.org/10.1007/BF00270610

Download citation

Key words

  • Lumbosacral lipomas
  • Lipomyelomeningoceles
  • Spinal-lipomas
  • Spina bidida
  • Occult spinal dysraphism
  • Fat metabolism