{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T01:16:24Z","timestamp":1761959784279,"version":"build-2065373602"},"reference-count":32,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2009,5]]},"abstract":"\nObject<\/jats:title>\nThe natural history of asymptomatic spinal lipoma in infancy remains unclear, and the indication for the prophylactic untethering operation is still debatable. To address this question, a multicenter cooperative study for the treatment of spinal lipoma was performed by the 7 most active institutions in neurosurgical care for spina bifida in Japan between 2001 and 2005.<\/jats:p><\/jats:sec>\n\nMethods<\/jats:title>\nPatients were classified using the embryopathogenetic surgicoanatomical classification. Their neurosurgical postoperative course was analyzed using the Spina Bifida Neurological Scale. Among 261 patients, 159 were asymptomatic and 102 were symptomatic.<\/jats:p><\/jats:sec>\n\nResults<\/jats:title>\nOf the 136 patients for whom prophylactic surgeries were performed, 135 remained asymptomatic and only 1 (0.4%) of the 261 patients presented with mild sensory disturbance. Mild foot deformity was identified in 1 (4.3%) of 23 conservatively observed patients. Of 100 symptomatic patients, deterioration after surgery was seen in 6%, and improvement in 44%. Complete resolution of symptoms was seen in only 14.2%. Filar types for patients > 3 years old improved in Spina Bifida Neurological Scale scores from 12.3 to 14.0. The mean age of symptomatic patients with lipomyelomeningocele was the youngest of all (1.3 years), which indicates lipomyelomeningocele may deteriorate in early infancy. Improvements from surgery were seen for all types of lipoma except the caudal type, presenting at an older mean age (15 years).<\/jats:p><\/jats:sec>\n\nConclusions<\/jats:title>\nA low rate of postsurgical worsening indicates that surgeries for asymptomatic and symptomatic lipomas are safe. Surgeries done after the onset of symptoms seldom cure the patients. These two results support early untethering for any kind of lipoma; however, further study of the natural history is required.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2009.1.peds08168","type":"journal-article","created":{"date-parts":[[2009,9,22]],"date-time":"2009-09-22T12:27:37Z","timestamp":1253622457000},"page":"412-419","source":"Crossref","is-referenced-by-count":19,"title":["Embryopathogenetic surgicoanatomical classification of dysraphism and surgical outcome of spinal lipoma: a nationwide multicenter cooperative study in Japan"],"prefix":"10.3171","volume":"3","author":[{"given":"Shizuo","family":"Oi","sequence":"first","affiliation":[{"name":"Division of Pediatric Neurosurgery, Department of Neurosurgery, The Jikei University Hospital Women's and Children's Medical Center, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sadahiro","family":"Nomura","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Department of Neurosurgery, The Jikei University Hospital Women's and Children's Medical Center, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masato","family":"Nagasaka","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Aichi Prefectural Colony\u2013Welfare Center for Persons with Developmental Disabilities, Kasugai, Aichi;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hajime","family":"Arai","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Juntendo University, Tokyo, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reizo","family":"Shirane","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Miyagi Children's Hospital, Sendai, Miyagi;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuo","family":"Yamanouchi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kansai Medical University, Moriguchi, Osaka;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Nishimoto","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Saitama Children's Medical Center, Saitama; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroaki","family":"Date","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Chiba Children's Hospital, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-0030412","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"857","DOI":"10.1007\/s007010170015","article-title":"Surgical experience of 120 patients with lumbosacral lipomas","volume":"143","author":"Arai","year":"2001"},{"key":"b2-0030412","series-title":"J Anat","first-page":"489","article-title":"The vertebral level of termination of the spinal cord during normal and abnormal development","volume":"106","author":"Barson","year":"1970"},{"key":"b3-0030412","series-title":"Neurosurg Rev","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1007\/s101430100177","article-title":"Clinical outcome differences for lipomyelomeningoceles, intraspinal lipomas, and lipomas of the filum terminale","volume":"24","author":"Bulsara","year":"2001"},{"key":"b4-0030412","series-title":"Childs Brain","first-page":"37","article-title":"Congenital intraspinal lipomas: anatomic considerations and surgical treatment","volume":"9","author":"Chapman","year":"1982"},{"key":"b5-0030412","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1097\/00006123-199901000-00113","article-title":"Spinal lipoma controversy","volume":"44","author":"Chapman","year":"1999"},{"key":"b6-0030412","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1007\/s00381-002-0624-x","article-title":"Congenital lumbosacral lipomas: pitfalls in analysing the results of prophylactic surgery","volume":"18","author":"Dorward","year":"2002"},{"key":"b7-0030412","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3171\/jns.1985.62.1.0001","article-title":"Management of lipomyelomeningoceles. 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