title: Surgical treatment of spinal lipoma without spina bifida at lumbar region-three case reports-.
abstract: Three men aged 40 to 60 years presented with rare lumbar spinal intradural lipomas without spina bifida manifesting as worsening numbness, pain of the lower extremities, and bladder dysfunction. All 3 patients underwent decompressive laminectomy. The lipoma and cauda equina nerves were dissected from the dura mater under the operating microscope, untethering the spinal cord and returning the cauda equina nerves to the original position. Duralplasty was performed using an expanded polytetrafluoroethylene sheet. Postoperatively, all patients experienced improvement of their neurological deficits. In the surgical treatment of spinal lipomas, the primary purpose is untethering and decompression, which can be achieved by untethering the spinal cord, returning the cauda equina nerves to the normal position, laminectomy, and duralplasty, without removal of the lipoma.
authors.affiliation: Department of Neurosurgery, Iwate Medical University School of Medicine, Morioka, Iwate, Japan. asuga@iwate-med.ac.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sugawara
authors.forename: Kyongsong
authors.initials: K
authors.lastname: Kim
authors.forename: Masanori
authors.initials: M
authors.lastname: Isobe
authors.forename: Ryoji
authors.initials: R
authors.lastname: Matsumoto
authors.forename: Toyohiko
authors.initials: T
authors.lastname: Isu
mesh_terms: D000328:Adult; D001099:Arachnoid / Q000473:pathology / Q000601:surgery; D002420:Cauda Equina / Q000473:pathology / Q000601:surgery; D019299:Decompression, Surgical / Q000379:methods; D004388:Dura Mater / Q000473:pathology / Q000601:surgery; D006801:Humans; D007796:Laminectomy / Q000379:methods; D008067:Lipoma / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods; D011128:Polyradiculopathy / Q000209:etiology / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications; D019919:Prosthesis Implantation / Q000379:methods; D019651:Plastic Surgery Procedures; D013115:Spinal Canal / Q000473:pathology / Q000601:surgery; D013116:Spinal Cord / Q000473:pathology / Q000601:surgery; D013117:Spinal Cord Compression / Q000209:etiology / Q000473:pathology* / Q000601:surgery*; D013125:Spinal Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome