Razack N, Jimenez O F, Aldana P, Ragheb J
Department of Neurological Surgery, University of Miami School of Medicine, Jackson Memorial Hospital, Florida, USA.
Neurosurgery. 1998 Feb;42(2):394-6; discussion 396-7. doi: 10.1097/00006123-199802000-00120.
Holocord intradural lipoma extending from the cervical to the lumbar spine is an exceedingly rare condition. An extensive review of the literature revealed that only eight other cases have been reported, and none occurred during the contemporary magnetic resonance imaging era.
A case of holocord intradural lipoma that was partially resected with the aid of carbon dioxide laser and intraoperative ultrasound is reported.
The intimate relationship of the lipoma to the nerve roots and the absence of a distinct plane between tumor and spinal cord precluded a complete resection of this tumor. At 7 months postoperatively, the patient's dysesthetic pain had resolved almost completely. Proprioception in the lower extremities had improved significantly to the point that the patient was able to walk without a cane and his preoperative Romberg's sign had disappeared.
Extensive intradural intramedullary spinal lipomas can present in adulthood with symptoms of myelopathy as well as nonradicular pain. We encourage early surgical debulking of the tumor to prevent further progression of symptoms and to offer the possibility of neurological improvement.
全脊髓硬膜内脂肪瘤从颈椎延伸至腰椎是一种极其罕见的病症。对文献进行广泛检索发现，仅有另外8例相关病例被报道，且在当代磁共振成像时代均未出现。
报告1例全脊髓硬膜内脂肪瘤病例，该病例在二氧化碳激光和术中超声辅助下进行了部分切除。
脂肪瘤与神经根关系密切，肿瘤与脊髓之间缺乏明显界限，这使得该肿瘤无法完全切除。术后7个月，患者的感觉异常性疼痛几乎完全缓解。下肢本体感觉显著改善，患者能够不用拐杖行走，术前的闭目难立征已消失。
广泛的硬膜内髓内脊髓脂肪瘤在成年期可表现为脊髓病症状以及非神经根性疼痛。我们鼓励早期对肿瘤进行手术减容，以防止症状进一步进展，并提供神经功能改善的可能性。
