Lipoma of the Cauda Equina

Abstract

Twelve cases of lipoma of the cauda equina are described with detailed neurological assessment and post-operative follow-up ranging from 3 to 19 months. The benign-looking subcutaneous lipoma is readily mistaken for a lumbosacral meningocele with normal skin cover. However, the stalk-like intradural extension of the lipoma is firmly adherent to the cauda equina and conus medullaris, and neurological complications are common. These affect mainly motor and bladder function. Early diagnosis is imperative and careful operative treatment before the onset of neurological signs may prevent the development of neurological complications. In cases with established neurological involvement, operation may in some instances produce improvement, while in others it may at least arrest the progression of the neurological deficit.