Prospective Evaluation of Outcome and Surgical Management of Conus Lipoma in Eastern India

Abstract Spinal lipomas are a group of spinal dysraphisms that most commonly present as closed spinal disorders associated with tethered cord syndrome. This is a pilot study spanning over 4.5 years, accounting for around 40 cases, aimed to conveniently study the demographic profile of the incidence, age, sex, clinical features, surgical outcome, complications, and follow-up of patients with conus lipomas. Also reviewed were the benefits and risks of prophylactic surgery as well as early versus late surgery. It is a prospective cohort study of review of the cases conducted over 4.5 years (between January 2019 and May 2023) at the Department of Neurosurgery, IMS and SUM Hospital, Bhubaneswar, Odisha, India, with a broad literature review done using search words “Conus” <AND/OR> “Spinal” <AND/OR> “Lipomas” spanning over academic articles indexed in PubMed, PubMed Central, NCBI, Embase, Scopus, and Google Scholar. A few home research articles written previously by a senior author of the current article were also cited. Data analysis was done using SPSS 22.0 for Windows for statistical computing. There was a 1.2:1 male-to-female ratio. The most common age group of the patients ranged between 1 and 5 years. The commonest symptom was swelling in the lower back, and the commonest neurological involvement was motor deficit with bladder dysfunction, subjectively. Most patients remained neurologically intact postoperatively. CSF collection and urinary retention were the most common post-op complications observed. Symptomatic conus lipoma patients underwent surgery readily, given the deficits. However, looking into all the neurological deficits babies can develop in the long run, our study proposes prophylactic and early surgeries in even asymptomatic babies. However large-scale randomized trials should be undertaken to review the claim and advise accordingly.