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Management of lumbosacral lipoma in childhood 

Management of lumbosacral lipoma in childhood
Chapter:
Management of lumbosacral lipoma in childhood
Author(s):

Martin M. Tisdall

, and Greg James

DOI:
10.1093/med/9780199656400.003.0006
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date: 12 April 2021

Lumbosacral lipoma is a form of occult spinal dysraphism. It occurs in 1:4000 live births and can lead to neurological, urological and orthopaedic disturbance. Until recently, the perceived surgical wisdom has been that all lumbosacral lipomas should be treated with surgical debulking and spinal cord detethering in an attempt to prevent neurological deterioration. This philosophy is based on the assumptions that inevitable deterioration will occur without surgery, and that surgery is safe and effective. Over the last decade evidence has emerged to suggest that, in the absence of neurological or urological deterioration, conservative management may have a similar or even superior outcome when compared to traditional surgical techniques. Conversely data from a recent single institution experience suggest that radical lipoma removal may lead to better outcome. This chapter presents a management algorithm for newly diagnosed patients with spinal lipomas which aims to recognize the benign course of the disease in many asymptomatic patients and to provide effective long term treatment results for those who deteriorate.

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