Outcome of Lipomyelomeningocele Surgery in Relation to Degree of Lipoma Debulking in Children: Challenges and Considerations

Background: Lipomyelomeningocele (LMMC) is an uncommon closed neural tube defect in which neural elements are incorporated within a spinal lipoma. This study aims to evaluate the clinical outcome of LMMC surgery in relation to the degree of intradural lipoma resection in children. Methods: This prospective study reported 25 children aged two months to six years who underwent surgical repair of LMMC from January 2021 to December 2024 at our institution. Preoperative evaluation included neurological assessment and MRI for all patients, whereas urodynamic studies were performed selectively in symptomatic children after achieving continence. Surgery involved resection of an intradural lipoma, pia mater repair, and sectioning of the filum terminale. Postoperative outcomes were assessed by neurological examination and urodynamic evaluation, as indicated. Results: A total of 25 children, including 10 males and 15 females, with a mean age of 25 ± 11.84 months, were reported. LMMC types were dorsal in 8 (32%), transitional in 5 (20%), and caudal in 12 (48%) cases. Resection of the intradural lipoma was total (100%) in 5 (20%), subtotal (>70%) in 10 (40%), partial (50%–70%) in 5 (20%), and debulking ( Conclusion: Surgery for LMMC is a safe and effective procedure for its management, with meticulous intradural resection and spinal cord untethering. Although not statistically significant, the degree of intradural lipoma resection correlates with the type of LMMC and postoperative events.