Lipomyelomeningocele

Last revised by Frank Gaillard on 29 May 2024

Lipomyelomeningoceles are one of the forms of closed spinal dysraphism. They usually present as a subcutaneous fatty mass just above the intergluteal cleft. However, some lipomyelomeningoceles may occur at other locations along the spinal canal.

Lipomyelomeningoceles may be clinically detectable as a subcutaneous fatty mass above the intergluteal crease.

These lesions are formed mainly due to a defect in primary neurulation in which mesenchymal tissue enters into the neural placode and forms lipomatous tissue.

It shows a non-specific splaying / non-fusion of the posterior elements of the spine, which usually cannot be differentiated from other spinal dysraphisms.

Ultrasound will show a vertebral arch defect associated with an elongated spinal cord with the placode attached to an intrathecal echogenic fatty mass that protrudes in the dorsal subcutaneous tissue. 

  • spina bifida

  • focal enlargement of the spinal canal at the placode level

  • hypodense fat-attenuated mass in continuity with the subcutaneous fat planes

  • typically seen as a spinal defect with lipomatous tissue, covered with skin

  • neural placode-lipoma interface lies outside the spinal canal due to enlargement of subarachnoid space

  • a low-lying cord is usually present

  • lipomyelocele: placode-lipoma interface lies within the spinal canal

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