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Child's Nervous System

, Volume 35, Issue 9, pp 1591–1597 | Cite as

Radical excision of lumbosacral lipoma: an early experience of “followers”

  • Sangjoon Chong
  • Ji Yeoun Lee
  • Kyung Hyun Kim
  • Hyung-Ik Shin
  • Keewon Kim
  • Kwanjin Park
  • Seung-Ki Kim
  • Kyu-Chang WangEmail author
Original Article
  • 48 Downloads

Abstract

Background

Indication, timing, and method for surgical treatment of lumbosacral lipoma are controversial. Radical resection of the lumbosacral lipoma and complete reconstruction of the placode are supported in that better long-term outcome can be achieved without increasing complication rate compared with traditional surgical techniques.

Objective

We analyzed the early surgical outcomes of lumbosacral lipoma treated with the untethering and radical excision of fat.

Methods

Retrospective analysis of surgically treated 81 fresh lumbosacral lipoma cases with dorsal, transitional, and chaotic types and true lipomyelomeningocele (LMMC) was performed. Caudal and filar types were excluded.

Results

Complete untethering was accomplished in 98%. Radical excision of the lipoma was attempted in all cases and achieved in 83%. Postoperative neurological complication was observed in 8 cases (10%). Group of lipoma types (dorsal + transitional vs. chaotic + true LMMC) and availability of radical lipoma excision turn out to be factors related to neurological outcomes in univariate analysis (p < 0.001 and p = 0.027, respectively). Group of lipoma types, availability of radical excision, and postoperative cord/dural sac (C/D) ratio are related factors in multivariate analysis (p = 0.025, p = 0.049, and p = 0.031).

Conclusions

As a follower of untethering and radical excision of fat, careful consideration is required to plan the surgery of lumbosacral lipoma on account of the “underestimated” complication rate. Type of the lipoma is the important factor determining the surgical outcome. Availability of complete radical excision and postoperative C/D ratio are the operative factors related to the neurological outcomes.

Keywords

Lumbosacral lipoma Neurological outcome Radical excision Complications Untethering 

Notes

Acknowledgments

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (2015R1A2A1A15055781).

Compliance with ethical standards

This study was approved by the Institutional Review Board (IRB) of the hospital. The waiver of consent was granted under IRB review.

Conflict of interest

There are no conflicts of interests.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Sangjoon Chong
    • 1
    • 2
  • Ji Yeoun Lee
    • 2
    • 3
  • Kyung Hyun Kim
    • 2
  • Hyung-Ik Shin
    • 4
  • Keewon Kim
    • 4
  • Kwanjin Park
    • 5
  • Seung-Ki Kim
    • 2
  • Kyu-Chang Wang
    • 2
    Email author
  1. 1.Department of NeurosurgeryAsan Medical CenterSeoulRepublic of Korea
  2. 2.Division of Pediatric NeurosurgerySeoul National University Children’s HospitalSeoulRepublic of Korea
  3. 3.Department of Anatomy, College of MedicineSeoul National UniversitySeoulRepublic of Korea
  4. 4.Department of Rehabilitation MedicineSeoul National University HospitalSeoulRepublic of Korea
  5. 5.Department of UrologySeoul National University HospitalSeoulRepublic of Korea

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