What are the spinal lipomas?
Spinal lipomas are a group of congenital malformations, ie that are already present at birth, that fall within the spectrum of hidden spina bifida.
In the lumbosacral lipoma a defect disjunction, separation between the different layers will cover the spinal cord in the embryo, so that an accumulation of lipoma, fatty tissue occurs, and connective tissue around the bone and its covers.
Finally this resulting anchor is a spinal cord. That lipoma spinal cord pulls down, anchoring it to the skin and causing the typical symptoms of lumbosacral lipoma.
What types are there?
Several types of spinal lipoma. The simplest is to classify them by their location, cervical, thoracic or lumbar, but perhaps the most interesting are the lumbosacral lipomas, those affecting the lower region of the spine, the conus. Conus lipomas are by far the most frequent in the clinic and also those who tend to produce symptoms more often.
What symptoms occur?
The symptoms of a spinal lipoma are highly variable. They can really range from a complete absence of symptoms, at least in certain period of life, until the appearance of more or less complex symptoms that can occur at any time of evolution.
There are patients who are already symptomatic at birth with orthopedic deformities or weakness in the leg muscles, while other patients will not develop symptoms until much later in the evolution of life.
Really any symptoms affecting the spinal cord and its coverings is possible when we are facing a lipoma. For example, in adulthood or adolescence the most typical symptom is back pain. It is a pain with mechanical characteristics and typically occurs when the patient is sitting or doing some action on trunk flexion or extension.
When symptoms occur earlier in children can range from a weakness in the lower limbs, with a more or less pronounced paresis of the extremities, usually the feet; orthopedic deformities, ie deformities in the shape of the feet, which do not stop being a sample of that muscle weakness that may occur through the spinal anchor, or even changes in bladder or bowel control.
Typically the most symptomatic lipomas, ie lipomas flows or transitional, can cause weakness in the lower extremities, weakness that can and often progressive, can cause changes in bladder or bowel control, ie, a neurogenic bladder, ability to control urination, or may cause alterations in the form, for example, constipation. Finally when consuming symptomatic lipoma time, it can result in spinal deformities such as scoliosis.
What is your diagnosis and treatment?
The diagnosis of lumbar lipoma is usually easy. Bulges usually seen in the lumbar region, subcutaneous lipomas, deviations from the gluteal fold for example, and occasionally cutaneous stigmata as vascular stain, an angioma, dimple, or areas of hypertrichosis, increase hairiness located.
When these symptoms occur lipomas is easy to detect a weakness of lower limbs, orthopedic impairment or the presence of these skin stigmata, that together we will lead to the diagnosis.
The diagnosis is finally magnetic resonance imaging, MRI of the lumbosacral region, we will diagnose and define the type of lipoma and treatment options.
Treatment of spinal lipomas, lumbosacral lipomas, is generally surgical. Fundamentally lipomas flow type or transitional lipomas are lipomas we consider high-risk, high risk of deterioration. That is, patients who throughout his life can or will file any of these anomalies that previously saw: muscle weakness, loss of bladder control or developmental problems of scoliosis.
While there lipomas that can persist asymptomatic throughout life, most of them go to and evolve result in these symptoms, which usually recommend a treatment that will be preventive or prophylactic those patients who have no symptoms or have not yet developed, and can be effective in controlling some of these symptoms and these patients have been able to develop the diagnosis.