PDF herunterladen
CC BY 4.0 · Indian Journal of Neurosurgery
DOI: 10.1055/s-0045-1808063
Original Article

Prospective Evaluation of Outcome and Surgical Management of Conus Lipoma in Eastern India

Abhijit Acharya 
1   Department of Neurosurgery, IMS and SUM Hospital, Bhubaneswar, Odisha, India
,
Satya Bhusan Senapati
1   Department of Neurosurgery, IMS and SUM Hospital, Bhubaneswar, Odisha, India
,
A.K. Mahapatra
1   Department of Neurosurgery, IMS and SUM Hospital, Bhubaneswar, Odisha, India
,
Souvagya Panigrahi
1   Department of Neurosurgery, IMS and SUM Hospital, Bhubaneswar, Odisha, India
,
Rama Chandra Deo 
1   Department of Neurosurgery, IMS and SUM Hospital, Bhubaneswar, Odisha, India
,
Soubhagya Tripathy
1   Department of Neurosurgery, IMS and SUM Hospital, Bhubaneswar, Odisha, India
,
Sumirini Puppala
2   Department of Neurology, IMS and SUM Hospital, Bhubaneswar, Odisha, India
› Institutsangaben
› Weitere Informationen
Auch verfügbar auf
   Lizenzen und Reprints

Abstract

Background

Spinal lipomas are a group of spinal dysraphisms that most commonly present as closed spinal disorders associated with tethered cord syndrome. This is a pilot study spanning over 4.5 years, accounting for around 40 cases, aimed to conveniently study the demographic profile of the incidence, age, sex, clinical features, surgical outcome, complications, and follow-up of patients with conus lipomas. Also reviewed were the benefits and risks of prophylactic surgery as well as early versus late surgery.

Methods

It is a prospective cohort study of review of the cases conducted over 4.5 years (between January 2019 and May 2023) at the Department of Neurosurgery, IMS and SUM Hospital, Bhubaneswar, Odisha, India, with a broad literature review done using search words “Conus” <AND/OR> “Spinal” <AND/OR> “Lipomas” spanning over academic articles indexed in PubMed, PubMed Central, NCBI, Embase, Scopus, and Google Scholar. A few home research articles written previously by a senior author of the current article were also cited. Data analysis was done using SPSS 22.0 for Windows for statistical computing.

Results

There was a 1.2:1 male-to-female ratio. The most common age group of the patients ranged between 1 and 5 years. The commonest symptom was swelling in the lower back, and the commonest neurological involvement was motor deficit with bladder dysfunction, subjectively. Most patients remained neurologically intact postoperatively. CSF collection and urinary retention were the most common post-op complications observed.

Conclusion

Symptomatic conus lipoma patients underwent surgery readily, given the deficits. However, looking into all the neurological deficits babies can develop in the long run, our study proposes prophylactic and early surgeries in even asymptomatic babies. However large-scale randomized trials should be undertaken to review the claim and advise accordingly.

Keywords

conus lipoma - spinal dysraphism - neurological deficits - swellings of lower back

Authors' Contribution

A.A. drafted the original manuscript, S.P. reviewed the literature, S.B.S. compiled the results, A.K.M. revised the final draft and conclusion, and R.C.D. prepared the figures and tables, and S.P. and S.T. finalized the manuscript.




Publikationsverlauf

Artikel online veröffentlicht:
01. Mai 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Pierre-Kahn A, Zerah M, Renier D. et al. Congenital lumbosacral lipomas. Childs Nerv Syst 1997; 13 (06) 298-334 , discussion 335
    CrossrefPubMedSuche in Google Scholar
  • 2 McLone DG, Naidich TP. Terminal myelocystocele. Neurosurgery 1985; 16 (01) 36-43
    PubMedSuche in Google Scholar
  • 3 Kumar A, Mahapatra AK, Satyarthee GD. Congenital spinal lipomas: role of prophylactic surgery. J Pediatr Neurosci 2012; 7 (02) 85-89
    PubMedSuche in Google Scholar
  • 4 Blount JP, Elton S. Spinal lipomas. Neurosurg Focus 2001; 10 (01) e3
    PubMedSuche in Google Scholar
  • 5 Dorward NL, Scatliff JH, Hayward RD. Congenital lumbosacral lipomas: pitfalls in analysing the results of prophylactic surgery. Childs Nerv Syst 2002; 18 (6–7): 326-332
    PubMedSuche in Google Scholar
  • 6 Kasliwal MK, Mahapatra AK. Surgery for spinal cord lipomas. Indian J Pediatr 2007; 74 (04) 357-362
    PubMedSuche in Google Scholar
  • 7 Chapman PH. Congenital intraspinal lipomas: anatomic considerations and surgical treatment. Childs Brain 1982; 9 (01) 37-47
    PubMedSuche in Google Scholar
  • 8 La Marca F, Grant JA, Tomita T, McLone DG. Spinal lipomas in children: outcome of 270 procedures. Pediatr Neurosurg 1997; 26 (01) 8-16
    PubMedSuche in Google Scholar
  • 9 Xenos C, Sgouros S, Walsh R, Hockley A. Spinal lipomas in children. Pediatr Neurosurg 2000; 32 (06) 295-307
    PubMedSuche in Google Scholar
  • 10 Pang D. Surgical management of complex spinal cord lipomas : a new perspective. J Korean Neurosurg Soc 2020; 63 (03) 279-313
    PubMedSuche in Google Scholar
  • 11 Pang D. Commentary to the article: asymptomatic lumbosacral lipomas: a natural history study, by Wykes V, Desai D, and Thompson DNP. Childs Nerv Syst 2012; 28 (10) 1741-1742
    PubMedSuche in Google Scholar
  • 12 Pang D. Surgical management of complex spinal cord lipomas: how, why, and when to operate. In: Di Rocco C, Pang D, Rutka J. eds. Textbook of Pediatric Neurosurgery. Cham: Springer; 2017
    Suche in Google Scholar
  • 13 Pang D. Total resection of complex spinal cord lipomas: how, why, and when to operate?. Neurol Med Chir (Tokyo) 2015; 55 (09) 695-721
    PubMedSuche in Google Scholar
  • 14 Kulkarni AV, Pierre-Kahn A, Zerah M. Conservative management of asymptomatic spinal lipomas of the conus. Neurosurgery 2004; 54 (04) 868-873 , discussion 873–875
    PubMedSuche in Google Scholar
  • 15 Manoranjan B, Pozdnyakov A, Ajani O. Neurosurgical management of conus lipoma in Canada: a multi-center survey. Childs Nerv Syst 2020; 36 (12) 3041-3045
    PubMedSuche in Google Scholar
  • 16 Hayashi C, Kumano Y, Hirokawa D, Sato H, Yamazaki Y. Long-term urological outcomes of spinal lipoma after prophylactic untethering in infancy: real-world outcomes by lipoma anatomy. Spinal Cord 2020; 58 (04) 490-495
    PubMedSuche in Google Scholar