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Journal of Korean Neurosurgical Society 1999;28(2): 221-227.
Outcome of Surgical Treatment for Lipomeningomyelocele.
Yong Bae Kim, Seung Woo Park, Dong Seok Kim, Joong Uhn Choi
Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.
ABSTRACT
Lipomeningomyelocele(LMMC) is one of the most common forms of occult spinal dysraphism seen in clinical practice. It is now widely accepted that prophylactic surgery is indicated in most cases, but areas of controversies were remained. From January 1986 to December 1996, long term data are available for 57 patients who underwent surgery for LMMC repair. The most common presenting symptom of these patients were mass on back which was followed by weakness of lower extremities and bladder-bowel symptoms. Transitional type was most common(53%) and followed by caudal(28%) and dorsal type(19%). Surgical repair was performed at age of 1 month to 40 years(mean age: 48months old, median 5 months old). Follow up for these patients ranged from 10 to 130 months(mean 50.3 months). None of the patients who underwent surgery before deficits had occured had ever developed new neurological deficits at the end of the follow up. However, 8 of 57 patients(14%) had aggravation of thier initial neurologic status by history preoperatively. Those progressive symptoms were somewhat reversed or stabilized in all of them postoperatively. In addition, surgical correction in infancy provides a degree of reversibility but do not in older children. We concluded that early diagnosis and treatment should be taken to prevent these progression and permanency of neurological changes.
Key Words: Lipomeningomyelocele; Spinal dysraphism; Tethered spinal cord; Timing of surgery; Prophylactic surgery
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