Lipomyelomeningocele: Pathology, Treatment, and Outcomes

A Review

Christina E. Sarris, B.S; Krystal L. Tomei, M.D., M.P.H; Peter W. Carmel, M.D; Chirag D. Gandhi, M.D.

Disclosures

Neurosurg Focus. 2012;33(4):e3 

In This Article

Epidemiology

The prevalence of lipomyelomeningocele and lipomeningocele has been found to range between 0.3 and 0.6 per 10,000 live births.[1,13,19,46] Agopian et al.[1] observed 14.4% of spina bifida cases were lipomyelomeningoceles during examination of the prevalence of spina bifida subtypes.

In general, neural tube defects have a complex origin in which both environmental and genetic factors play a role. There is substantial evidence that maternal dietary folic acid supplementation can reduce the risk of neural tube defects among offspring.[21] However, studies[13,19,46] have reported no reduction in rates of lipomyelomeningocele following folic acid fortification, suggesting that the pathogenesis of lipomyelomeningocele is fundamentally different from that of other neural tube defects. Forrester and Merz[19] also reported higher lipomyelomeningocele rates in infants born to mothers in younger and older age groups. Spinal dysraphisms have been found to be more common among Hispanics, and less common among non-Hispanic blacks than non-Hispanic whites.[1] Compared with non-Hispanic whites, Hispanics had an even higher prevalence of lipomyelomeningocele and lipomeningocele than of myelomeningocele, meningocele, and myelocele subtypes of spinal dysraphisms.[1] Maternal obesity has been associated with an increased risk of neural tube defects, suggesting that the embryonic environment for development may be metabolically different for obese women,[60,62] but no particular spinal dysraphism phenotype was observed to explain the overall increased risk.[60] Familial forms of lipomyelomeningocele are rare, with only 2 previous reports.[23] A report of lumbar lipomyelomeningocele and sacrococcygeal teratoma in siblings suggested an inherited regional tendency to developmental error affecting the caudal embryonic segments.[53]

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