[Surgical methods and techniques of lipomyelomeningocele in children].

OBJECTIVE: To investigate the methods and techniques of surgical treatment of lipomyelomeningocele in children. METHODS: From January 2004 to March 2007, twenty-five children aged from 2 months to 6 years with lipomyelomeningocele were operated on. Magnetic resonance imaging and electromyogram had been conducted to all the patients. The operation was composed of subtotal excision of lipomas, suture of spinal pia mater and resection of terminal filum. The results of treatment were evaluated by Hoffman's functional grading scheme for lipomyelomeningocele. RESULTS: After operation, all the patients recovered and were released from hospital. No complications, including cerebrospinal fluid leakage and infection occurred. During the follow-up of 1 - 4 years, 18 asymptomatic patients' neurological function were normal and there was no deterioration, 7 symptomatic patients improved. Among the 7 patients, 4 patients had higher function grades compared with their preoperative assessments, and the other stayed in the same grades but with symptoms improved. Magnetic resonance imaging showed no tethered cord in all the patients postoperatively. CONCLUSIONS: For lipomyelomeningocele, early operation should be performed to prevent the development of neurological defect. It is safe and effective to adopt subtotal excision of lipomas, suture of spinal pia mater, and resection of terminal filum.