Surgical Treatment Of Lipomyelomeningocele In Children

Objective:To report the lipomyelomeningocele patients treated by the department of neurosurgery in the First Affiliated Hospital of Xinjiang Medical University from January 2013 to APril 2017 in Xinjiang Region.Methods:A total of 35 cases of lipomyelomeningocele were treated from January 2013 to April 2017,aged from 1 day to 10 years old.Lumbosacral MRI examinations were performed routinely before the operation for all patients.Hoffman lipomyelomeningocele function classification was used to judge the preoperative,postoperative and follow-up curative effect.21 cases were followed up for 6 months to 3 years.The follow-up rate was 60% and the mean follow-up period was 27.62 months.Results:32 patients had primary healing of the incision.3 patients suffered from cerebrospinal fluid leakage and repaired with cerebrospinal fluid leakage in time,and they all recovered very well without severe complications such as intracranial infection.29 cases of preoperative normal nerve function were normal and postoperative neurological function was normal as well.5 cases of neurological symptoms were not deteriorated after operation.1 patient had neurological function before operation,and the neurological function grading was deteriorated after operation.Postoperative long-term follow-up results:preoperative 18 patients were normal neurological function,of which 12 Patients developed graded deterioration during follow-up-9 patients neurological function increased from grade 0 to 2,2 patients were elevated to grade 1,and 1 patient was elevated to grade 4,and of which 6 patients were normal neurological function,and the average age of treatment was 7.16 months.The visiting age of 3 patients with neurological symptoms before surgery was 42.33 months,of which 1 cases neurological function improved and decreased from grade 1 to 0,and of which 2 patients preoperative function grading was grade 2 and remained stable during follow-up.Conclusion:The key to lipomyelomeningocele treatment is mainly early operation,and to ensure better surgical results and improve patient prognosis,the abnormal change of lumbosacral skin such as a hairy nevus,skin dimples,and cutaneous hemangiomas should be paid much attention to.