Lipomeningomyelocele

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Classification according to ICD-10
Q05. Spina bifida - meningomyelocele
ICD-10 online (WHO version 2019)

The Lipomeningomyelozele (LMM) is a special form of a Dysraphism ( meningomyelocele , MMC) with additional existing spinal lipoma . The fat portions exceed the lumbodorsal fascia with displacement of the dura mater and infiltrate parts of the cone and / or the filum terminale . As a result, they can both make surgical removal of the neural plate more difficult and also represent an additional cause of tethering.

The abbreviation "LMM" was used in 1971 by HM Rogers and co-workers.

The name “lipomeningomyelocele” also comes from 1997 by A. Pierre-Kahn and colleagues.

Classification

For the surgical procedure and its success, the location of the attachment of the lipoma to the cone and the related position of the posterior nerve roots are decisive. The modified classification according to Chapman is based on this .

  • Dorsal shape with attachment to the cone that merges into the dural defect and further caudally reaching dural sac
  • Caudal shape with transition of the bulbous, distended cone into the lipoma
  • Intermediate form as a hybrid of these two.

diagnosis

Evidence fatty shares of MMC can by shortly after birth ultrasound done, the precise extent by means of magnetic resonance imaging detected.

literature

  • H. Resorlu, F. Gokmen et al .: A rare cause of spinal dysraphism: lipomeningomyelocele. In: The Spine Journal. Vol. 16, 2016, p. E415, doi: 10.1016 / j.spinee.2015.12.024
  • PS Patil, A. Gupta, PL Kothari, G. Kekre, R. Gupta, V. Dikshit, K. Mudkhedkar, K. Kesan: Immediate and long-term outcome analysis of lipomeningomyelocele repair in asymptomatic infants in a tertiary care center. In: Journal of pediatric neurosciences. Vol. 11, No. 2, 2016 Apr – Jun, pp. 99–104, doi: 10.4103 / 1817-1745.187619 , PMID 27606014 , PMC 4991178 (free full text).
  • HC Ludwig, HC Bock: Reconstructive and plastic operations in pediatric neurosurgery In: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW , Bd. 2, Doc 04, 2013, doi : 10.3205 / iprs000024 , urn : nbn: de: 0183-iprs0000245
  • A. Kumar, AK Mahapatra, GD Satyarthee: Congenital spinal lipomas: Role of prophylactic surgery. In: Journal of Pediatric Neurosciences. Vol. 7, No. 2, May 2012, pp. 85-89, doi: 10.4103 / 1817-1745.102562 . PMID 23248681 . PMC 3519090 (free full text).
  • D. Pang, J. Zovickian, A. Oviedo: Long-term outcome of total and near-total resection of spinal cord lipomas and radical reconstruction of the neural placode, part II: outcome analysis and preoperative profiling. In: Neurosurgery. Vol. 66, No. 2, February 2010, pp. 253-272, doi: 10.1227 / 01.NEU.0000363598.81101.7B , PMID 20042988 .

Individual evidence

  1. ↑ AJ Barkovich: Pediatric Neuroimaging. 2nd edition, Raven 1995, ISBN 0-7817-0179-1 , p. 494
  2. ↑ aiimsnets.org Neurosurgery Education
  3. ^ HM Rogers, DM Long, SN Chou, LA French: Lipomas of the spinal cord and cauda equina. In: Journal of neurosurgery. Vol. 34, No. 3, March 1971, pp. 349-354, doi: 10.3171 / jns.1971.34.3.0349 , PMID 4926270 .
  4. ↑ A. Pierre-Kahn, M. Zerah, D. Renier, G. Cinalli, C. Sainte-Rose, A. Lellouch-Tubiana, F. Brunelle, M. Le Merrer, Y. Giudicelli, J. Pichon, B. Kleinknecht, F. Nataf: Congenital lumbosacral lipomas. In: Child's nervous system: ChNS: official journal of the International Society for Pediatric Neurosurgery. Vol. 13, No. 6, June 1997, pp. 298-334, PMID 9272285 (review).
  5. ↑ PH Chapman: Congenital intraspinal lipomas: anatomic considerations and surgical treatment. In: Child's brain. Vol. 9, No. 1, 1982, pp. 37-47, PMID 7060411
  6. ↑ W. Oakes: Management of spinal cord lipomas and lipomyelomeningoceles In: RH Wilkins, SS Rengachary (Ed.): Neurosurgery Update II , Vol. 3, pp. 3497-3504, New York, McGraw-Hill, 1991
  7. ^ V. Hofmann, KH Deeg, PF Hoyer: Ultrasound diagnostics in paediatrics and pediatric surgery. Textbook and atlas. Thieme 2005, ISBN 3-13-100953-5 .
  8. ↑ W. Schuster, D. Färber (editor): Children's radiology. Imaging diagnostics. Springer 1996, ISBN 3-540-60224-0 . Vol. I, p. 530

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