title: Neurosurgical management and pathology of lumbosacral lipomas with tethered cord.
abstract: Lumbosacral lipomas are the most common form of occult spinal dysraphism. The development of lumbosacral lipomas is from the premature disjunction of the neural tube from the surrounding ectoderm, leaving the neural plate open posteriorly and allowing for the infiltration of mesodermal tissue, including fatty tissue. Since lumbosacral lipomas are a common cause of spinal cord tethering that can lead to progressive neurological deficits, prophylactic neurosurgery for lumbosacral lipomas, including untethering of the spinal cord, is recommended. We briefly review the embryology, classification, clinical presentation, imaging evaluation, surgical indication, neurosurgical management and pathological examination that are involved in recognizing these complicated malformative pathologies.
authors.affiliation: Department of Neurosurgery, Fukuoka Children's Hospital, Fukuoka, Japan.
authors.forename: Takato
authors.identifier: http://orcid.org/0000-0003-2114-2756
authors.initials: T
authors.lastname: Morioka
authors.affiliation: Department of Neurosurgery, Fukuoka Children's Hospital, Fukuoka, Japan.
authors.forename: Nobuya
authors.initials: N
authors.lastname: Murakami
authors.affiliation: Department of Neurosurgery, Fukuoka Children's Hospital, Fukuoka, Japan.|Department of Neurosurgery, Kyushu University, Fukuoka, Japan.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Shimogawa
authors.affiliation: Department of Neurosurgery, Kyushu University, Fukuoka, Japan.
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Mukae
authors.affiliation: Department of Neurosurgery, Kyushu University, Fukuoka, Japan.
authors.forename: Kimiakai
authors.initials: K
authors.lastname: Hashiguchi
authors.affiliation: Department of Neuropathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Satoshi O
authors.initials: SO
authors.lastname: Suzuki
authors.affiliation: Department of Neurosurgery, Kyushu University, Fukuoka, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Iihara
mesh_terms: D006801:Humans; D008067:Lipoma / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D008161:Lumbosacral Region / Q000473:pathology; D009436:Neural Tube Defects / Q000209:etiology / Q000473:pathology* / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods; D012983:Soft Tissue Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery*
keywords: lumbosacral lipomas; occult spinal dysraphism; premature disjunction; tethered cord; untethering