Pediatric Spinal Lipomas: Insights from a Single Institution’s Experience in Surgical Management of 55 Cases

Background: Spinal lipomas are congenital malformations often associated with spinal dysraphism and neurological deficits in pediatric patients. Surgical management aims to alleviate symptoms and prevent neurological deterioration. This retrospective analysis presents the clinical characteristics, surgical outcomes, and long-term follow-up of 55 pediatric patients with spinal lipomas managed at a single institution. Materials and Methods: The medical records of pediatric patients diagnosed with spinal lipomas between 2018 and 2023 were reviewed and followed up for 1.6 years (1–3 years). Demographic data, clinical presentation, radiological findings, surgical approaches, intraoperative details, postoperative complications, and long-term outcomes were collected and analyzed. Results: The study included 55 patients with a mean age of 10 years 9 months (13 days–17 years). Magnetic resonance imaging revealed filum terminale lipoma (43.6%, n = 24), caudal type (23.6%, n = 13), dorsal type (10.9%, n = 6), lipomyelomeningocele (12.7%, n = 7), and the mixed type (9%, n = 5). Surgical approaches varied based on lipoma location, with intraoperative neurophysiological monitoring utilized to minimize neurological complications. Postoperative complications occurred in 27.3% (n = 15) of patients, including cerebrospinal fluid leakage, urinary retention, and wound dehiscence. Long-term follow-up demonstrated a 21.8% rate of secondary tethering. Conclusion: This retrospective analysis provides valuable insights into the surgical management and outcomes of pediatric patients with spinal lipomas. Understanding clinical characteristics and surgical techniques can aid in optimizing patient care and improving long-term outcomes. © 2025 Journal of Pediatric Neurosciences.