Muthusubramanian Vikram, Pande Anil, Vasudevan Madhabushi Chakravarthy, Ramamurthi Ravi
Post Graduate Institute of Neurological Surgery, Dr Achanta Lakshmipathi Neurosurgical Centre, VHS Hospital, Chennai 600113, India.
Surg Neurol. 2008 Mar;69(3):314-7. doi: 10.1016/j.surneu.2007.01.062. Epub 2007 Sep 4.
Lipomas of the spinal cord are often a component of spinal dysraphic states. Nondysraphic intramedullary spinal cord lipomas are rare, and concomitant isolated cervical and lumbar intradural intramedullary lipomata are very rare. One patient with concomitant isolated nondysraphic cervical and lumbar spinal cord lipomata has been reported and management options discussed.
A young girl presented with insidious-onset diffuse neck pain and early myelopathic signs. Conventional radiographs were normal. Magnetic resonance imaging of the whole neuraxis revealed concomitant cervical and lumbar intradural intramedullary lipoma. Subtotal resection of the lesion was performed at both levels, after which the patient improved symptomatically and was ambulant independently.
Concomitant intradural lipomas at 2 different locations unassociated with a dysraphic state is very rare. Magnetic resonance imaging with fat suppression study is the investigation of choice. Adequate decompression with subtotal removal is the treatment of choice.
脊髓脂肪瘤常为脊髓发育异常状态的组成部分。非发育异常性髓内脊髓脂肪瘤罕见，而同时存在孤立的颈段和腰段硬膜内髓内脂肪瘤则极为罕见。已有1例伴有孤立的非发育异常性颈段和腰段脊髓脂肪瘤患者的报道，并讨论了治疗方案。
一名年轻女孩出现隐匿性发作的弥漫性颈部疼痛和早期脊髓病体征。常规X线片正常。全神经轴磁共振成像显示同时存在颈段和腰段硬膜内髓内脂肪瘤。在两个节段均进行了病变的次全切除，术后患者症状改善，可独立行走。
同时存在于2个不同部位且与发育异常状态无关的硬膜内脂肪瘤非常罕见。脂肪抑制磁共振成像是首选的检查方法。次全切除并充分减压是首选的治疗方法。
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