Lipomyelomeningoceles: A neuroradiological approach

The results of a retrospective study of 10 cases of lipomyelomeningocele (LMML) and 4 cases of spinal lipoma in reoperated LMML observed over a 4-year period are reported. Patient's age ranged from 4 months to 12 years; a slight female predominance was noted (8:6). All patients underwent myelography, followed by CT-myelography in 11. MRI was performed in 1 patient. In 6 cases myelography and CT-myelography were performed under narcosis during the same session, while in the remaining cases CT scan followed myelography within 3 hours. Clinical features, divided into orthopaedic, urological and neurological deficits, were correlated with radiological findings divided into vertebral bone lesions, radicular lesions and spinal lesions. Since a complete neuro-radiological study is mandatory in the pre-operative phase to decide on the opportunity, type and timing of surgery, neuroradiological end-points are defined. The diagnostic pattern in these patients has to be carefully prepared through an interdisciplinary approach in order to reduce the anaesthesiological and surgical risks, while waiting for an ultrasound and MRI protocole as first-line examination.