[Lumbosacral lipomas with spina bifida. Anatomo-clinical correlations. Therapeutic results]

From 1971 to 1982, the authors saw 41 patients who presented lumbo sacral lipomas with spina bifida; 9 remained outpatients and had regular clinical follow up; the other 32 were operated on; 1 was lost sight of, shortly after the operation. 40 patients were then regularly followed; of these, 15 (37%) developed neurological deficits (14 before and 1 long after surgery). Intraspinal lipomas were classified into 2 groups: group I (18 cases), when the lipomas displaced but did not include the lumbo sacral roots; group II (14 cases) when it included most or all of these roots. Despite an inevitably less satisfactory liberation of the spinal cord in the group II, post operative results were not significantly different in the 2 groups. Comparing the post operative results of this series to others in the literature, the authors come to the following 3 conclusions: 1) these operations are benign; 2) they are all the more effective when the neurological deficits are either recent or evolutive, and 3) they protect most of the patients from eventual neurological deterioration. Therefore the authors agree that patients with lumbo sacral lipomas should be operated on at the onset of neurological deficits but also recommend early intervention, even in the absence of any neurological disturbance.