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Intraoperative Ultrasound in Spinal Surgery
Published on: August 17, 2022
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Pathogenesis of spinal intramedullary lipomas: two case reports
Luis Miguel Moreno Gómez1, Daniel García-Pérez2, Pedro Juan González-León2
1Neurosurgery Department, University Hospital "12 de Octubre", Avda de Córdoba, s/n, 28041, Madrid, Spain. lmmg.neurosurgery@gmail.com.
Journal of Medical Case Reports
|July 24, 2023
Summary
Spinal lipomas without spinal dysraphism are rare. Two cases showed recurrence and progression, suggesting these lesions may not be benign and require long-term monitoring, especially in young patients.
Area of Science:
- Neurosurgery
- Developmental Biology
Background:
- Spinal lipomas unassociated with spinal dysraphism are rare.
- Their natural history and long-term outcomes remain largely unknown.
Observation:
- Two cases of spinal lipomas (cervicothoracic and craniocervical) in young patients (19-year-old female, 14-year-old male) were surgically resected.
- Both patients experienced clinical progression, with one having a progressive course and the other experiencing worsening after recurrence from prior surgeries.
Findings:
- Despite surgical resection with neurophysiological monitoring and intraoperative ultrasound, both cases demonstrated recurrence and progression during long-term follow-up.
- This challenges the assumption of a purely benign, malformative etiology for these specific spinal lipomas.
Implications:
- Young patients with spinal lipomas may have a more aggressive disease course requiring vigilant, long-term surveillance.
- Metabolic or hormonal factors could influence disease progression, and reoperation should be considered upon detecting neurological decline.
