Lipomyelomeningocele

Lipomyelomeningocele (LMMC) is a form of spinal dysraphism involving a lipomatous malformation of the distal spinal cord. Physical examination may reveal cutaneous markers such as subcutaneous fat pads, asymmetric gluteal cleft, atypical dimples, hemangiomas, or atretic tails. A complete work-up should include magnetic resonance imaging to assess the anatomy of the lipomatous malformation, as well as associated findings in the spinal axis such as syringomyelia, Chiari malformation, or additional dysraphic elements. Patients with LMMC carry a high risk for deterioration of urologic and neurologic function. Untethering of the spinal cord and resection of the lipoma should be considered. Difficulties with incision healing, including leakage of cerebrospinal fluid, are common complications of surgical treatment and can be minimized with meticulous closure and close post-operative monitoring.