title: The role of flexible hollow core carbon dioxide lasers in resection of lumbar intraspinal lipomas.
abstract: OBJECTIVE
  The authors assess the role of flexible hollow core CO2 laser system (Omniguide system) in resection of intraspinal lipomas.
  
  
  METHODS
  Eight patients with intraspinal lipomas were operated using an Omniguide laser system over a 22-month period. The age range varied between 6 months and 16 years. All of them had lipoma of the conus medullaris associated with lumbar subcutaneous lipoma. Two of these had previous surgery with resection of the subcutaneous part of the lipoma; in one of them, a partial resection of the conus medullaris lipoma had also been performed. In six, there were no obvious motor or sensory deficits whereas two had gross neurologic deficits, with the deficits occurring in one after the previous decompression. Resection of the conus lipoma, untethering of the spinal cord, and reconstruction of the decompressed conus was performed in all aided with Omniguide laser system. The power settings of the laser system ranged from 4 to 8 W.
  
  
  RESULTS
  Subtotal to near-total resection was achieved in all. None of the patients developed any new motor or sensory deficits. Three had postoperative CSF leaks which initially required reoperation with graft resuturing and subsequently placement of lumboperitoneal shunt. One child with preexisting neurologic deficits improved in power over the next 12 months.
  
  
  CONCLUSIONS
  Flexible CO2 laser system was precise and convenient in decompressing the conus lipomas and untethering of the cord in lumbar spinal lipomas.
authors.affiliation: Division of Neurosurgery, University of Texas Medical Branch at Galveston, 301 University Boulevard, Rt. 0517, Galveston, TX 77555-0517, USA.
authors.forename: Sohum Kiran
authors.initials: SK
authors.lastname: Desai
authors.forename: David
authors.initials: D
authors.lastname: Paulson
authors.forename: Bobbye Jo
authors.initials: BJ
authors.lastname: Thompson
authors.forename: Joel
authors.initials: J
authors.lastname: Patterson
authors.forename: Aaron
authors.initials: A
authors.lastname: Mohanty
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D007223:Infant; D054020:Lasers, Gas / Q000627:therapeutic use*; D008067:Lipoma / Q000601:surgery*; D008161:Lumbosacral Region / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D019635:Neurosurgical Procedures / Q000295:instrumentation* / Q000379:methods*; D011859:Radiography; D019651:Plastic Surgery Procedures; D013116:Spinal Cord / Q000000981:diagnostic imaging / Q000601:surgery; D013120:Spinal Cord Neoplasms / Q000601:surgery*; D016896:Treatment Outcome