A lipoma is a spinal tumor that forms as a result of impaired embryonic development. This is an uncommon neoplasm that consists of adipose tissue and a fibrous framework. The tumor has a soft and elastic consistency and grows very slowly, so symptoms manifest themselves only after a few years. The disease is treated with surgery. You can undergo your treatment in Germany, where it will be safe and ensure reliable long-term results. You are welcome to visit the Booking Health website to find out the cost of treatment in Germany and choose a medical care program at the best price.
- What is a spinal cord lipoma?
- How is spinal cord lipoma surgery performed?
- Results of surgical treatment of spinal cord lipomas
- Benefits of surgical treatment of spinal cord lipomas in Germany
What is a spinal cord lipoma?
A lipoma is a neoplasm consisting of adipose tissue. This neoplasm develops in the spinal cord very rarely. The cause of the formation of lipomas in the central nervous system is the displacement of precursor adipose cells into the primary neural tube during embryonic development. Since the disease is congenital, children are predominantly affected.
Lipomas are often combined with anomalies in the spinal column structure, which also require treatment.
The main symptoms are the following:
- spinal curvature, namely scoliosis;
- spinal nerve root compression, resulting in pain, numbness of the innervated areas, and paresis (severe weakness) of the lower extremities;
- pelvic floor dysfunction, including urinary incontinence.
Lipomas are classified as intramedullary (located inside the spinal cord) and extramedullary (located in the area of the meninges). They mainly form on the posterior surface of the spinal cord and are most often localized in the lumbosacral region.
Lipoma symptoms usually progress slowly, and, at the time of treatment, most tumors are 3 to 5 cm in size.
An MRI scan is considered the best method for diagnosing the disease. The tumor gives exactly the same signal as the subcutaneous adipose tissue. With an MRI scan, doctors can determine the location of the tumor, its size and shape, and also optimally plan treatment.
Since spinal cord lipomas are often part of a complex of congenital anomalies, patients additionally have MRI scans of the brain, craniovertebral junction, and cervical level of the spinal cord. Vertebral anomalies, a dermal sinus (a fistula between the skin and spinal cord), and diastematomyelia (separation of the spinal cord by a septum) are frequent findings.
How is spinal cord lipoma surgery performed?
Whether a child needs treatment depends on the size of the lipoma, its growth rate, and the presence of symptoms. If symptoms are present, treatment is always required. If the lipoma is asymptomatic and has a minimal size at the time of detection, treatment can be postponed using only dynamic monitoring. Every year, a child is examined for any neurological disorders and the pace of tumor growth. Rapid growth may be a reason for a decision about the need for surgical treatment, including before the onset of symptoms.
The main treatment for lipomas is a microsurgical resection. When performing the operation, a doctor pursues the following goals:
- as complete as possible and, ideally, total lipoma removal;
- preservation of normal spinal cord tissue to avoid any neurological deficits;
- restoration of normal spinal cord anatomy.
A standard surgical procedure is performed using an open approach. Doctors perform a laminectomy (removal of the vertebral arches), after which they excise lipomas. The liquid part of the tumor can be destroyed by ultrasound and sucked off with an aspirator. The fibrous framework of the tumor is removed with scissors or a bipolar coagulator. Doctors at some hospitals can evaporate the lipoma with a laser.
Lipoma removal surgery is followed by the elimination of the spinal cord fixation: they restore the normal anatomical structure, form the subarachnoid space, and perform dura mater plastic surgery, restoring the muscular fascial frame. The wound will then be sutured in layers.
German doctors use neurophysiological monitoring during surgery, which makes it safer as doctors can determine which areas of the spinal cord are functionally important and not damage them during the operation.
Results of surgical treatment of spinal cord lipomas
Lipoma removal can be total, subtotal, or partial.
The neoplasm is delimited from the normal tissue of the spinal cord, so doctors can usually perform a total or subtotal resection. If a lipoma cannot be removed completely, the objective is to resect more than 95% of the tumor. If the volume of the tumor is less than 1 cubic centimeter, the risk of recurrent tumor growth that may cause symptoms is small.
Doctors in Germany usually manage to completely remove the tumor, ensuring that it does not recur in the future.
The most undesirable option is a partial resection. In this case, the tumor will grow larger again, and half of the patients will have symptoms again within 10 years.
About 60% of patients do not have any symptoms after surgery. In another 35%, they are significantly relieved within a year after the operation. In 5% of cases, all neurological symptoms still remain. The chances of their disappearance are higher in those patients in whom the manifestations of the disease have developed recently. The long-term persistence of symptoms reduces the likelihood of significant improvement after surgery. However, even for such patients, surgery is beneficial, as neurological disorders will no longer progress after lipoma removal.
Sometimes treatment can be provided before the onset of symptoms. For example, if doctors see a lipoma growing while monitoring a patient. In this case, the best treatment results can be achieved as the symptoms do not manifest themselves at the time of the operation and will never appear in the future after tumor removal.
Benefits of surgical treatment of spinal cord lipomas in Germany
Doctors at German hospitals use state-of-the-art equipment, including powerful surgical microscopes, intraoperative neuromonitoring, and various types of intraoperative imaging (for example, ultrasound scans). Doctors use not only mechanical instruments but also a laser, bipolar coagulation, and ultrasonic destruction and aspiration of the tumor to remove it. These techniques are more sparing and provide less blood loss and minimal damage to healthy spinal cord tissue.
Surgical interventions are performed with minimal bone resection to maintain the stability of the spine. Instead of a laminectomy (removal of the vertebral arches), doctors may perform a laminotomy (removal of only part of the arch). As a result, not only is the volume of bone resection reduced, but muscles and ligaments are better preserved.
There are a few reasons for you to undergo your treatment in Germany. These are the following:
- high-quality preoperative diagnostics that allow for optimal treatment planning;
- German hospitals are equipped with state-of-the-art equipment;
- operations are less traumatic;
- the stability of the spine is maintained;
- safe treatment of patients of any age, including children in their first year of life;
- simultaneous treatment of spinal cord lipomas and other anomalies in the development of the central nervous system can be provided;
- doctors can use a laser, ultrasound, or bipolar coagulation in the process of lipoma removal;
- less blood loss;
- the normal anatomy of the spinal cord is completely restored;
- doctors mostly manage to remove the lipoma completely, not partially;
- a low risk of recurrence;
- intraoperative neuromonitoring is used during surgical treatment to avoid damage to the functionally important spinal cord tissues;
- the cost of treatment in Germany is relatively low as compared to other developed countries.
After your treatment at German hospitals, you can undergo rehabilitation. It will help you recover faster after surgery and get rid of most neurological symptoms. Within a few months, patients can return to their normal lives without any restrictions.
You are welcome to use the Booking Health service to get medical services in Germany at a good price. On our website, you can find the best hospitals in the country and see the cost of treatment in Germany. When you make your treatment appointment through Booking Health, the prices will be lower than when you contact the hospital directly. The cost of treatment in Germany will be reduced due to the lack of taxes for foreign patients.
It is quite easy to select a hospital on our website. Medical centers can be sorted by price, rating, reviews, and the nearest possible appointment date. The Booking Health employees will help you make your choice and arrange your trip.
The article was edited by medical experts, board-certified doctors Dr. Nadezhda Ivanisova and Dr. Vadim Zhiliuk. 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!
National Spine Health Foundation