Introduction

Spinal cord lipomas are lumps made of fat cells in the lower spinal canal, near or around the spinal cord.

The spinal cord is a bundle of nerves that connect the brain to the body, helping your child move and feel things. It sits inside the spinal column. 

The spinal canal is a tunnel made of 33 small bones called vertebrae. It protects the spinal cord. 

Lipomas can grow as your child grows and can cause the spinal cord to attach to the wall of the spinal canal. This is called tethered cord syndrome and needs surgery to fix.

A lipomyelomeningocele is a large fatty lump of cells that pushes out through a gap in the spine. It is soft, uneven and can be seen under the skin on the back or bottom after birth. The spinal cord can attach to the fatty mass on the back or bottom, causing issues with movement or function.

Spinal lipomas and lipomyelomeningoceles grow early in pregnancy and are linked to spina bifida. Spina bifida is a condition where the spine and spinal cord do not grow properly.

A spinal cord lipoma may not be noticeable at birth, with the cells causing issues under the skin, inside the spinal cord.

Lipomyelomeningoceles are usually seen at birth or become noticeable within the first few months. The lump is usually covered by skin and is not painful.

Signs and symptoms often happen when the spinal cord is pulled, especially during growth spurts.

Your child may have:

• weakness in the legs
• muscle spasms and stiffness
• differences in foot growth that cause tripping or walking difficulties
• changes in bladder and bowel control or function
• scoliosis - gradual curving of the back.

Spinal cord lipomas are sometimes found by accident during scans done later in life, or when signs and symptoms start to appear.

Lipomyelomeningoceles can sometimes be seen on ultrasound scans during pregnancy. 

After birth, lipomyelomeningoceles are diagnosed based on the results of:

• an ultrasound scan of the spine and lump
• an X-ray to show a gap in the spine
• an MRI scan to get a more detailed picture and help plan surgery.

Your child may also need tests to check how their bladder is functioning.

Surgery is often needed to untether the spinal cord to stop any long-term damage and prevent future problems.

This surgery is usually done in your child’s first year, when they can safely have a general anaesthetic. 

If symptoms return as your child grows, they may need surgery again.

The surgeon may also reduce the size of the fatty lump under the skin. This can increase the risk of complications like:

• necrosis – when fatty cells die
• infection
• fluid leakage
• new scar tissue.

The spinal cord may become tethered again as your child grows, and more surgery may be needed.