Preventive Surgery for Asymptomatic Spinal Lipomas in Children.

IF 0.9 4区医学 Q4 CLINICAL NEUROLOGY

Turkish neurosurgery Pub Date : 2024-01-01 DOI:10.5137/1019-5149.JTN.31209-20.2

Ding Gao, Nan Bao, Bo Yang, Yun-Hai Song, Shou-Qing Sun

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引用次数: 0

Abstract

Aim: To explore the clinical effect and significance of preventive surgery for asymptomatic spinal lipomas in children.

Material and methods: We retrospectively analysed the clinical data of 168 patients with asymptomatic spinal lipoma from April 2001 to June 2019, Shanghai Department of Neurosurgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine. The patients were aged from 1.5 months to 15 years (the average age was 7 months), and there were no neurological symptoms, such as pain, incontinence, and/or bilateral lower limb dysfunction, before surgery. The surgical procedure included completely removing the lipomas in subcutaneous and extramedullary tissues of the spinal cord, subtotal resection of intraspinal fat, and separating the spinal cord, including the medullary conus from the dura sac, to release the tethered cord.

Results: For the 168 children with spinal lipomas included in the study, complete resection was undertaken for the dorsal spinal lipomas, and subtotal resection was performed for the transitional lipomas. Subcutaneous effusion caused by cerebrospinal fluid leakage occurred in 5 cases after surgery and was cured after multiple punctures and aspiration. Six patients developed mild incontinence immediately after the operation, 5 of whom completely returned to normal within 1 month, and 1 had no relief of symptoms. A total of 159 of the 168 patients were followed up for 3 to 19 years (the median follow-up time was 76 months). Longterm postoperative symptoms were observed in 13 patients (7.7%), including 12 cases of spinal cord retethering and 1 case of lipoma enlargement.

Conclusion: Preventive surgery can reduce the future incidence of neurological dysfunction in children with asymptomatic spinal lipomas.

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儿童无症状脊柱脂肪瘤的预防性手术。

目的：探讨儿童无症状脊柱脂肪瘤预防性手术的临床效果及意义：回顾性分析上海交通大学医学院附属上海儿童医学中心神经外科2001年4月至2019年6月168例无症状脊柱脂肪瘤患者的临床资料。患者年龄为1.5个月至15岁（平均年龄为7个月），术前无疼痛、大小便失禁和/或双下肢功能障碍等神经系统症状。手术方法包括完全切除脊髓皮下和髓外组织中的脂肪瘤，次全切除椎管内脂肪，并将脊髓（包括髓锥）与硬脑膜囊分离，以释放系带脊髓：在168名脊柱脂肪瘤患儿中，背侧脊柱脂肪瘤完全切除，过渡脂肪瘤次全切除。术后有 5 例患者出现脑脊液漏引起的皮下积液，经过多次穿刺和抽吸后治愈。6 例患者在术后立即出现轻度尿失禁，其中 5 例在 1 个月内完全恢复正常，1 例症状无缓解。对 168 名患者中的 159 人进行了 3 至 19 年的随访（中位数随访时间为 76 个月）。13名患者（7.7%）出现了术后长期症状，其中12例出现脊髓拴系，1例出现脂肪瘤增大：结论：预防性手术可降低无症状脊柱脂肪瘤患儿未来神经功能障碍的发生率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Turkish neurosurgery 医学-临床神经学

CiteScore

1.50

自引率

12.50%

发文量

126

审稿时长

2 months

期刊介绍： Turkish Neurosurgery is a peer-reviewed, multidisciplinary, open access and totally free journal directed at an audience of neurosurgery physicians and scientists. The official language of the journal is English. The journal publishes original articles in the form of clinical and basic research. Turkish Neurosurgery will only publish studies that have institutional review board (IRB) approval and have strictly observed an acceptable follow-up period. With the exception of reference presentation, Turkish Neurosurgery requires that all manuscripts be prepared in accordance with the Uniform Requirements for Manuscripts Submitted to Biomedical Journals.