title: Adult cervicothoracic lipomyelomeningocele.
abstract: Lipomyelomeningocele (LMM) as a cause of tethered cord syndrome (TCS) commonly presents in childhood in the lumbosacral spine. Patients frequently present with cutaneous manifestations, progressive neurological deterioration, bladder dysfunction, and intractable pain. Early surgical intervention with untethering is recommended for symptomatic patients. We report an unusual case of a woman who presented with a subcutaneous lump, pain, and neurological decline found to have a cervicothoracic LMM. The patient underwent laminectomy and subtotal resection of the mass; seventeen years later she was confined to a wheelchair with severe neurological decline ultimately requiring three additional attempts at surgical excision and repair. This case emphasizes the need for early recognition of and intervention in adult patients with LMM.
authors.affiliation: Department of Neurosurgery, The Johns Hopkins University School of Medicine, 733 N Broadway, Baltimore, MD 21205, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Abu-Bonsrah
authors.affiliation: Department of Neurosurgery, The Johns Hopkins University School of Medicine, 733 N Broadway, Baltimore, MD 21205, USA.
authors.forename: Taylor E
authors.initials: TE
authors.lastname: Purvis
authors.affiliation: Department of Neurosurgery, The Johns Hopkins University School of Medicine, 733 N Broadway, Baltimore, MD 21205, USA.
authors.forename: C
authors.initials: C
authors.lastname: Rory Goodwin
authors.affiliation: Department of Neurosurgery, The Johns Hopkins University School of Medicine, 733 N Broadway, Baltimore, MD 21205, USA.
authors.forename: Rory J
authors.initials: RJ
authors.lastname: Petteys
authors.affiliation: Department of Neurosurgery, The Johns Hopkins University School of Medicine, 733 N Broadway, Baltimore, MD 21205, USA.
authors.forename: Rafael
authors.initials: R
authors.lastname: De la Garza-Ramos
authors.affiliation: Department of Neurosurgery, The Johns Hopkins University School of Medicine, 733 N Broadway, Baltimore, MD 21205, USA. Electronic address: Dsciubb1@jhmi.edu.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Sciubba
mesh_terms: D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D006801:Humans; D007796:Laminectomy / Q000379:methods; D008591:Meningomyelocele / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D009436:Neural Tube Defects / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging* / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cervicothoracic; Lipomyelomeningocele; Spine; Tethered cord syndrome