Clinical analysis of dorsal type lipoma tethered cord syndrome in children

Objective By analyzing children's dorsal type lipoma tethered cord syndrome(TCS) clinical data, we aim to discuss the method and curative effect of surgical treatment. Methods From May 2011 to March 2016, retrospective analyses were performed for 92 cases of dorsal type lipoma TCS. Microsurgical treatment was offered along with intraoperative electrophysiological monitoring. Surgical procedures consisted of whole vertebral plate resection, retaining broken vertebral plate-spine microscopically, cutting spinal canal lipoma surface, ultrasonic aspiration of removed lipoma, capsular lipoma and dura mater of suture and anatomical repositioning vertebral plate. Kirollos and Hoffman grading systems were used for evaluating the efficacy of surgical treatment. The follow-up period ranged from 11 to 63 months. Results The rate of lipoma total resection was 77.1%(71/92), anatomical repositioning rate of vertebral plate 95.6%(88/92), total curing rate 47.2%(43/91), total effective rate 87.9%(80/91) and complication rate 7.6%(7/92). Children aged under 3 years undergoing total resection had better outcomes. Urinary dysfunction improved more obviously than lower limb dysfunction. Cure might be obtained without neurologic symptoms. Conclusions The above treatment is effective with fewer postoperative complications and has a high curing rate in asymptomatic TCS children. Key words: Tethered cord syndrome; Lipoma; Microsurgical technique