Surgical strategies and outcomes for intradural lipomas over the past 20 years. (February 2019)

• Record Type: Journal Article
• Authors: Ikeda, Norimasa; Odate, Seiichi; Shikata, Jitsuhiko; Yamamura, Satoru; Kawaguchi, Shinji
• Is Part Of: Journal of clinical neuroscience. Volume 60(2019)
• Page Start: 107
• Page End: 111
• Publication Date: 2019-02
• Subjects: Spinal tumor -- Lipoma -- Resection -- Surgery -- Outcome; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2018.10.010
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Postoperative outcomes after excessive (>60%) or total tumor resection are poor. The mean time from initial surgery to recurrence of intradural lipomas is 11 ± 7 years. Duraplasty may increase the space inside the dura mater and prevent recurrence. Partial resection and duraplasty produce the best outcomes for intradural lipoma. Abstract: Intradural lipoma is an extremely rare spinal tumor. The boundary between the spinal cord and the lipoma is usually unclear, with adhesions being firm. Thus, total resection of the tumor is difficult and the neurological prognosis after total resection is poor. Information on the management of this type of tumor is scarce owing to the limited studies that have been conducted and the low sample sizes reported. Here, we report a case and provide a review of the literature on intradural lipomas over the past 20 years. In addition to describing our case, we reviewed reports published in Pubmed and CiNii. The demographic data of the patients included in these studies were extracted and the surgical procedures were assessed, along with their corresponding postoperative outcomes. There were 57 primary cases and 4 cases of recurrence. Among the primary cases, the neurological symptoms were persistent in 54 (95%) after surgery. The postoperative outcomes after excessive (>60% tumor resection) or total resection were significantly poor. In the recurrence cases, the mean period from initial surgery to recurrence was 11 years and all initial surgical procedures involved only partial resection surgery. This report is, to the best of our knowledge, the most exhaustive analysis of cases of intradural lipomas and recurrences. The optimal treatment for lipoma necessitates both partial resection and duraplasty.