Spinal Lipomas

Jeffrey P. Blount, MD, and Scott Elton, MD, Division of Neurosurgery, University of Alabama at Birmingham, Children's Hospital of Alabama, Birmingham, Alabama

Neurosurg Focus. 2001;10(1) 

In This Article

Diagnosis of Lipoma of The Terminal Filum

Signs and Symptoms

Typically a lipoma of the terminal filum only comes to attention when clinically manifest as part of the tight filum syndrome. In this syndrome a tethered cord results from a failure of ascension of the normal conus medullaris due to constriction from the robust filum. Lipomas of the filum may remain clinically silent during childhood and become apparent during a period of rapid growth associated with adolescence. Characteristically this is first manifest as progressive low-back pain.[11] Often this pain is posture related and may be worsened with stretching, vigorous physical activity, or physical contact including sports. Lipomas of the conus medullaris (lipomyelomeningocele) and lipomas of the filum induce injury to the spinal cord via a tethering mechanism. As such, it is not surprising that many characteristics of the early symptoms are identical. Similarly the progressive neurological decline associated with lipomyelomeningocele may be seen in patients with a lipoma of the terminal filum.

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