Prevention of Adhesion after Removal of Lumbosacral Lipoma with Tethered Cord by Using Interposition Silastic Sheet : A Case Report

Authors

  • Pataravit Rukskul Neurosurgical Unit, Division of Surgery, Department of Clinical Science, Faculty of Medicine, Thammasat University, Thailand.
  • Yongyuth Siripakarn Division of Orthopedics, Department of Clinical Science, Faculty of Medicine, Thammasat University, Thailand

Keywords:

Lumbosacral lipoma, Silastic sheet, Tethered cord

Abstract

             A 13-year-old boy was admitted to Thammasat University Hospital, Pathumthani, Thailand in January 2000 with a history of 1 0-year progressive pain, paraparesis and urinary incontinence. At birth, he has had a soft tissue lump over the spine in the lumbosacral area with no associated cutaneous anomalies. The MR images demonstrated a transitional lumbosacral lipoma. The lipoma was surgically removed and the lateral spinal cord and filum terminale were released from dural adhesions. A silastic sheet was inserted to interpose at the excision site for prevention of cord adhesion. The postoperative results were extremely gratified by the disappearance of pain from tethered spinal cord with gradual recovery of muscular atrophy and urinary incontinence within 8 months following surgery. This report showed a simple and safe application of silastic sheet to prevent postoperative adhesion after removal of a congenital lumbosacral lipoma.

References

1. Chapman PH, Congenital intraspinal lipomas: Anatomic considerations and surgical treatment. Child's Brain 1982;9:37-47.

2. Chapman PH, Beyerl B. The tethered spinal cord, with particular reference to spinal lipoma and distematomyelia. In: Hoffman HJ, Epstein F, eds. Disorder of the developing nervous system. Boston: Blackwell Scientific, 1986: 109-31.

3. Shintani T. Experimental studies on prevention of adhesion of tissue surrounding dura mater and morphological changes in the spinal cord following laminectomy (Abstract). Nippon Seikeigeka Gakkai Zasshi. 1980; 54: 1477-95.

4. Boop FA, Chadduck WM. Silastic duraplasty in pediatric patients. Neurosurgery 1991; 29: 785-7; discussion 788.

5. Ohe N, Futamura A, Kawada R, et al. Secondary tethered cord syndrome in spinal dysraphism. Childs Nerv Syst 2000;16(7): 457-61.

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Published

2000-12-28

How to Cite

1.
Rukskul P, Siripakarn Y. Prevention of Adhesion after Removal of Lumbosacral Lipoma with Tethered Cord by Using Interposition Silastic Sheet : A Case Report. Thai J Surg [Internet]. 2000 Dec. 28 [cited 2024 Apr. 18];21(4):129-32. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/243336

Issue

Vol. 21 No. 4 (2000): October - December

Section

Case Reports

License

Articles must be contributed solely to The Thai Journal of Surgery and when published become the property of the Royal College of Surgeons of Thailand. The Royal College of Surgeons of Thailand reserves copyright on all published materials and such materials may not be reproduced in any form without the written permission.