Related Experiment Video
Updated: Nov 22, 2025
Surgical Approach and Complications of Stand-alone Lateral Trans-Psoas Interbody Fusion
Published on: February 14, 2025
Early- and long-term surgical outcomes in 109 children with lipomyelomeningocele
Tarang K Vora1, Shabari Girishan1, Ranjith K Moorthy1
1Department of Neurological Sciences, Christian Medical College Hospital, Vellore, Tamil Nadu, 632004, India.
Insights
Surgery for lipomyelomeningocele (LMMC) can preserve neurological function in most children. Early intervention in symptomatic cases improves outcomes, while radical resection is key for long-term results.
Area of Science:
- Pediatric Neurosurgery
- Spinal Dysraphism Research
- Surgical Outcomes Analysis
Background:
- Lipomyelomeningocele (LMMC) is a congenital condition requiring surgical intervention.
- Understanding functional outcomes and risk factors is crucial for optimizing patient care.
- Previous studies have varied in their focus on early versus long-term results.
Purpose of the Study:
- To determine the functional outcomes of surgery for lipomyelomeningocele (LMMC) in children.
- To identify risk factors associated with both early and long-term outcomes after LMMC surgery.
- To evaluate the impact of surgical timing and extent on neurological preservation and recovery.
Main Methods:
- Retrospective analysis of data from 109 children with LMMC who underwent surgery between 2008 and 2017.
- Evaluation of neurological function at presentation, post-operatively, and during long-term follow-up.
- Statistical analysis to identify risk factors for early and delayed neurological deterioration and functional recovery.
Main Results:
- No significant risk factors for early post-operative outcomes were identified.
- Long-term follow-up showed improvement in 27.6% of symptomatic children, with 68.4% remaining stable.
- Early surgery after symptom onset in children over 1 year old was linked to better recovery (p = 0.0008).
- Presence of syrinx on initial MRI (p = 0.008) and partial lipoma resection (p = 0.02) were risk factors for delayed deterioration.
Conclusions:
- Radical resection of LMMC appears to preserve neurological function in over 90% of children long-term.
- Surgical intervention for LMMC can lead to functional recovery, particularly in bladder dysfunction.
- Timely surgical intervention for symptomatic LMMC is associated with improved neurological outcomes.
Aim:
To determine the functional outcomes and risk factors for outcomes following surgery for lipomyelomeningocele (LMMC).
Methods:
Data from 109 children with LMMC who underwent surgery from January 2008 to December 2017 were retrospectively studied to evaluate functional outcomes and possible risk factors for early- (at discharge from hospital or within 1 month of surgery) and long-term outcomes after surgery.
Results:
There were 53 boys and 56 girls with median age of 36 months (IQR 12-90 months; range, 4 months to 18 years) at surgery. At presentation, neurological function was normal (asymptomatic group) in 28 (25.7%) children while there was neurological dysfunction (symptomatic group) in 81 (74.3%). Near total or radical excision of lipoma was done in 71 (65.1%) children. Six (5.8%) children had deterioration of neurological function in the post-operative period with recovery of function in three of them. There were no statistically significant risk factors for early outcomes. At a mean follow-up of 62.5 months (IQR 35-82 months; range, 12-146 months), 21 (27.6%) of the 76 symptomatic group children (including 59.3% with incomplete bladder dysfunction) showed improvement, 52 (68.4%) remained the same, while 3 (4%) deteriorated. In 31 children (symptomatic group) who developed symptoms after 1 year of age, early surgery after development of symptoms was associated with better chances of recovery (p = 0.0008). In the asymptomatic group, 23 (88.5%) had normal neurological function at mean follow-up of 57.5 months (IQR 30-77 months; range, 12-141 months) and 3 (11.5%) had neurological deterioration. The mean time to late deterioration (re-tethering) from surgery was 51.3 months (IQR 24-75 months; range, 24-84 months). Presence of syrinx on initial MRI (p = 0.008) and partial resection of the lipoma (p = 0.02) were independent risk factors for delayed deterioration.
Conclusion:
Radical resection of LMMC probably helps in preserving neurological function in > 90% of children at long-term follow-up. Fifty-five percent of children > 2 years of age with incomplete bladder dysfunction regained normal function following surgery. In children who develop symptoms after birth, early surgical intervention can reverse the neurological deficits.
