[Lumbosacral spina bifida associated with an intraspinal lipoma]

Area of Science:

• Neurology
• Developmental Biology
• Neurosurgery

Background:

• Spina bifida is a congenital neural tube defect occurring early in gestation.
• Intraspinal lipomas are a known, though less common, association with spina bifida.
• Early diagnosis and intervention are crucial for managing associated neurological deficits.

Observation:

• A case of occult spina bifida was identified during evaluation for back pain.
• The patient presented with cutaneous, orthopedic, and neurological signs.
• Imaging revealed both extra- and intradural lipoma associated with the spina bifida.

Findings:

• Clinical symptoms, including tethered cord syndrome, result from spinal cord compression by the lipoma.
• Neurological symptoms typically manifest in childhood but can present later in adulthood, often with sphincter dysfunction.
• Computed tomography (CT) and magnetic resonance imaging (MRI) are effective diagnostic tools for intraspinal lipomas.

Implications:

• This case underscores the importance of considering intraspinal lipomas in patients with spina bifida, even with subtle presentations.
• Prompt surgical intervention is indicated for symptomatic intraspinal lipomas to prevent further neurological damage.
• Understanding the varied clinical manifestations is key for timely diagnosis and management of these complex spinal malformations.