Treatment of Spinal Cord Lipoma

A lipoma is a rare tumor of the spinal cord. It is mainly diagnosed in children, as it is a congenital defect. The lipoma does not always manifest symptoms and requires treatment. But sometimes it causes severe neurological symptoms, and in such cases, surgical removal of the tumor is required. You can undergo the treatment of the disease abroad. In the best hospitals in the world, minimally traumatic, safe spinal cord surgeries are performed.

Content

1. What is a spinal cord lipoma?
2. Diagnostics
3. Treatment
4. Why it is worth undergoing treatment abroad

What is a spinal cord lipoma? 

A lipoma (a fatty lump) is a benign tumor from adipose tissue. It usually develops in the subcutaneous fatty tissue of various parts of the body. 

Much less often, these neoplasms occur in the central nervous system. They account for 0.5% of brain tumors, and they are even less common in the spinal cord.

These are congenital formations. They develop due to dystopia (displacement) of embryonal fat cells into the neural tube of the fetus. In other words, they are the result of impaired embryogenesis.

In most cases, tumors are located in the lumbar region. The lipoma is often combined with congenital defects in the structure of the spinal column. The diameter of the tumor is usually small, but sometimes it reaches 3-5 cm.

Topographically (by localization), the following types of lipomas are distinguished: 

• Intradural extramedullary (outside the spinal cord). 
• Intramedullary lipomas (in the tissue of the spinal cord). 
• Filum terminale lipomas. 

A rare form of the disease is epidural lipomatosis. With this form of pathology, a large amount of adipose tissue is formed under the dura mater. It compresses the spinal cord, causing compressive myelopathy or compression of the cauda equina roots (end segment of the spinal cord).

Diagnostics 

A spinal cord lipoma, unlike a similar tumor in the brain, usually causes symptoms. Most children with this neoplasm develop scoliosis – a lateral curvature of the spinal column. Radicular symptoms are often detected:

• Pain. 
• Decreased sensitivity in the areas of innervation of the involved spinal nerve.
• Leg weakness. 
• Urinary incontinence and other signs of pelvic dysfunction. 

The tumor itself can be detected using MRI or CT scanning. It is identified by its density: it is the same as that of adipose tissue.

Treatment 

The treatment is not always required. Sometimes the lipoma is minimal in size, only a few millimeters, and does not cause any symptoms or complications. In this case, only medical supervision of the child is required.

Indications for treatment: 

• Compression of the spinal cord and nerve roots, the onset of symptoms.
• Compression of blood vessels.
• Impaired cerebrospinal fluid outflow. 
• Fixed spinal cord syndrome. 

The treatment is technically difficult, since the lipoma is fused with the brain matter, nerve roots and blood vessels. When trying to separate it, doctors can inflict a significant injury and there is a risk of developing an irreversible neurological deficit.

The main methods of lipoma removal are as follows: 

• Classical microsurgical operation on the spinal cord with tumor resection. The doctor removes the vertebral arch (laminectomy), after which he removes the formation with microscissors.
• Ultrasonic destruction and aspiration of adipose tissue. The doctor uses ultrasound to liquidize the lipoma. The medical specialist then sucks this liquid through a thin tube. The advantage of the method is that it is minimally invasive. However, there is a drawback: only adipose tissue is removed, and the fibrous frame of the tumor remains. It can be additionally removed with microscissors.
• Laser removal of the lipoma. Minimally invasive tumor evaporation procedure. The doctors usually manage to remove only part of the neoplasm.
• Traction bicoagulation dissection – the doctors dissect the tumor with a bipolar coagulator under tension.

In each case, the attending physician individually decides whether it is worth removing the whole tumor or only its part. A total removal can lead to a severe neurological deficit: impaired bladder function, impaired sensitivity or mobility of the lower extremities.

Why it is worth undergoing treatment abroad

The specialists abroad use the very latest technologies, which allow to remove the tumor safely, as completely as possible. The high-precision diagnostic examinations help to avoid the development of the neurological deficit.

When the tumor is removed, intraoperative neurophysiological studies are performed. The surgeons also use neuronavigation. The doctors apply ultrasound, CT or MRI scanning to imagine the tumor during the surgical procedure.

Here are some of the benefits of treatment abroad: 

• There is no overtreatment: small "clinically silent" lipomas are not removed, because the operation may cause complications.
• It is possible to reduce the size of the lipoma using minimally invasive procedures such as ultrasound destruction and aspiration.
• Microsurgical interventions with minimal damage to the tissues surrounding the tumor are performed.
• Modern methods for bleeding control are used, which seal the vessels and minimize blood loss.
• Intraoperative diagnostics reduces the risk of severe neurological deficit to zero, since the doctor does not damage the functionally important tissues of the spinal cord. 
• It is possible to conduct simultaneous treatment of lipoma and malformations, which are often found in children with this disease.

To undergo spinal cord lipoma treatment abroad, please use the services of Booking Health. We will help you find the most suitable clinics for the treatment of lipoma abroad and take care of the organization of your trip. On the Booking Health website, you can compare prices for surgical resection of lipoma and book a medical care program at a favorable price. The cost of treatment for you will be lower due to the lack of additional coefficients for foreign patients.

Authors: 

The article was edited by medical experts, board-certified doctors Dr. Vadim Zhiliuk and Dr. Sergey Pashchenko. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!

Sources:

National Library of Medicine

Verywell Health

The Lancet