Intraspinal lipomas in infancy and childhood causing a tethered cord syndrome.

The authors report on a series of 26 children with spina bifida occulta in combination with intraspinal lipoma and clinical signs of tethered cord syndrome. The age of the children at presentation ranged from 1 month to 12 years. The typical signs and symptoms consisted of skin lesions in the lumbar-sacral region, neurogenic foot deformities, and bladder and bowel disturbances. The diagnosis was confirmed by neuroradiological investigations including lumbar myelography, computerized tomography, and only recently magnetic resonance imaging. Indications for surgery were based on the radiological evidence of intraspinal lipoma and tethered cord and especially on the clinical signs of neurological deterioration. The results of the operative treatment are presented and the role of surgery before onset of symptoms as well as during the symptom-free interval is discussed.