[Lumbosacral lipoma: computed tomographic scan findings and surgical correction]

Display of the specific anatomic derangements by high-resolution computed tomographic (= CT) scan provides an important basis for planning corrective surgery of lumbosacral lipoma. In this paper, analysis of four infants and a child with lumbosacral lipoma revealed following discrepancy between the image by CT scan and operative finding. Most of lipoma showed a sharply outlined area of low density (approximately -100 H.U.) in the CT scan. Lipoma in the spinal cord parenchym represented intermingled fatty and neural tissue. There were also relatively high density areas in some cases and correspondingly, there were very fibrous lipomas, which could be identified by microscopic histological examination. Although there was a general correlation between the site of lumbosacral skin abnormality and underlying intraspinal lesion, some case does not match perfectly. In conclusion, a removal of the lumbosacral lipoma for the tethering effect always preferable to a total extirpation even though with technological advances in operative magnification and surgical instrumentation and a removal of the compressing lamina is necessary for adequate decompression.