Surgical treatment of lipomyelomeningocele

He Qiang; Ji Wenyu; Tukebai·Tuertuoheti; Abulikemu·Yiminjiang; Liu Yuan; Li Yabin; Wang Zengliang; Wang Yongxin

doi:10.11850/j.issn.1009-122X.2018.03.001

Abstract：Objective To investigate the effect of surgical treatment for lipomyelomeningocele (LMM). Methods Clinical data of 20 LMM patients were analyzed retrospectively, including Hoffman grade 0 in 17 patients, grade 1 in 1 and grade 2 in 2. The surgical outcome was evaluated as follows: compared with preoperation, reduction or no change of Hoffman classification was considered effective, and increase of the classification deteriorative. The untethering degree of tethered system during the operation was evaluated by Kirollos and Hille technique. Results Twenty patients were followed up for mean time of 27.6 months, ranging from 6 to 36 months. Untethering grade one was achieved in 11 patients and grade two in 9 according to Kirollos and Hille technique. There were 6 patients with Hoffman grade 0, 1 with grade 1, 12 with grade 2 and 1 with grade 4 after the operation. The response rate was 55％ (11/20 patients), and deterioration was seen in 9 patients (45％). No serious complications occurred. Conclusions The surgical treatment of LMM should be comprehensively considered of various factors, including surgical timing, the extent of tumor excision, untethering degree of tethered nerve, assessment of surgical outcome, postoperative follow-up and so on for improving surgical outcome.