Clinical characterization of post-surgical outcomes and associated risk factors of lipomyelomeningocele in Eastern India
Keywords:
Cerebrospinal fluid; Lipomeningomyelocele; Neural tube defect; Spina bifida; Tethered cord; Wound infectionAbstract
Background: Lipomyelomeningocele (LMMC), the most complex spinal lipoma and a common spinal malformation, can cause complications ranging from bladder dysfunction to significant neurological deficits. Therefore, prompt diagnosis and treatment are essential.
Aims and Objectives: The study aims to determine post-operative complications, functional outcomes, and risk factors in LMMC patients.
Materials and Methods: This prospective observational study included 40 LMMC patients who underwent surgery, regardless of age and sex. Demographic, clinical, pre-operative, radiological, intraoperative, and post-operative data were recorded. Patients were followed for 4 months to assess complications (early and late) and risk factors associated with them.
Results: Of 40 patients, most were 0–3 years with male predominance (57.5%). The lumbosacral region (47.5%) was the most common anatomical site, and transitional lipoma was the most frequent type (40%). Detethering was performed in all 40 patients, with total lipoma excision achieved in 67.5%. Post-operative complications occurred in 42.5% (17 patients): 13 experienced early complications (cerebrospinal fluid leak [7], infection [4], wound dehiscence [2]), and four experienced late complications (neurological deficit [1], pseudomeningocele [3]). Clinically, 7.5% of patients had developed new neurological deficits. Factors associated with complications included: Age 3–6 years (P=0.02), A-positive blood type (P=0.01), lumbosacral/sacral location (P=0.014), dorsal/chaotic/terminal lipoma type (P<0.001), and partial lipoma excision with iatrogenic injury (P=0.001) using a patching technique (P=0.001). Post-operative proning reduced the risk of complications (P<0.001).
Conclusion: Our study demonstrates that detethering with complete lipoma excision, dural closure using glue, and post-operative proning improve outcomes and reduce post-operative complications in LMMC patients.
Downloads
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Asian Journal of Medical Sciences
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with this journal agree to the following terms:
- The journal holds copyright and publishes the work under a Creative Commons CC-BY-NC license that permits use, distribution and reprduction in any medium, provided the original work is properly cited and is not used for commercial purposes. The journal should be recognised as the original publisher of this work.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
