Lipomyelomeningocele

What is a lipomyelomeningocele?
This is a congenital lesion that is associated with Spina Bifida (congenital failure of closure of the spinal bones). This is associated with abnormal fat accumulation that starts below the level of the skin and extends through the bony opening to the spinal cord. The lesion itself is composed of a descended conus medullaris infiltrated by fat, which continues out of a dural, bony, and fascial defect to emerge as a skin-covered subcutaneous mass that is usually found in the lumbosacral region. An intramedullary lipoma is a lipoma of the conus medullaris that does not extend outside the dura.

Who gets lipomyelomeningoceles?
These lesions become evident within the first few months to the first years of life. This lesion affects females more than males in a 1.5 to 1 ratio.

What are the symptoms of a lipomyelomeningocele?
More than 90% of patients will have an obvious soft tissue swelling over the spine in the lumbosacral region. These lesions are covered by skin and are not painful. Patients may lose neurological function within the first few weeks after birth but more typically the time course for deterioration is over a period of months to years. The neurological symptoms are usually weakness and bladder and bowel incontinence. The weakness may be symmetrical or asymmetrical and may result in atrophy of the lower extremities. In older adolescents and adults, pain may be the driving force to bring the patient in for clinical evaluation. The pain may be difficult to describe; it may be radiating in nature. There may be a limitation of back mobility.

It is important to note that the effects from spina
bifida are extremely varied. They range from
severe physical deformation and developmental
problems to minor bladder problems usually
correctable by surgery. The most common effects
are limited use of lower limbs, bowel and bladder
limitations, and average mental capability. Spina
bifida is usually accompanied by one or more other
conditions.