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Lipomyelomeningocele

What is a lipomyelomeningocele?

A lipomyelomeningocele (pronounced lipo-myelo-men-IN-go-seal) is a birth defect of a child’s spine.

It is a fatty mass starting under the skin on the child’s back, usually in the middle. The mass extends inward to the spinal canal. It is covered in skin and is usually visible from outside the child’s body.

The two biggest problems with lipomyelomeningocele in children are:

  1. The spinal cord is stuck (fixed) to the fatty mass
  2. The fatty mass puts pressure on the spinal cord

Who gets a lipomyelomeningocele?

This is a rare defect. It only occurs in one to two infants per 10,000 live births. It is slightly more common in girls.

The defect happens early in the mother’s pregnancy — about the fourth to sixth week — and has no known cause. Unlike a myelomeningocele, it does not have a genetic component nor is it due to a lack of folic acid during pregnancy.

A lipomyelomeningocele that can invade the spinal cord and cause weakness and bladder problems.
A lipomyelomeningocele that can invade the spinal cord and cause weakness and bladder problems.

What is your experience with lipomyelomeningocele?

Children’s has extensive experience with infants and children with lipomyelomeningoceles.

Children with this condition often have complex problems so we bring doctors from different specialties together in one clinic to treat them. Neurosurgery is one part of that team.

Other doctors refer about five to 10 infants with this condition to Children’s each year. Our neurosurgeons have a great deal of experience closing and repairing lipomyelomeningoceles.

We use the latest and best neuromonitoring equipment during each baby’s surgery.

About 30 percent of infants with a lipomyelomeningocele develop spinal cord tethering as they grow. In a tethered spinal cord, the spinal cord is stuck in the fat and scar tissue and pulled downward. Symptoms can occur — see tethered spinal cord. Children’s neurosurgeons are also very experienced at detethering the cord.

What surgery do you use to treat lipomyelomeningocele?

Because this lesion is covered with skin, we don’t do a lipomyelomeningocele repair until a baby is 4 - 8 months old.

If the fatty mass is not removed and the spinal cord remains tethered, neurological damage happens over time. Slowly, she will lose sensory and movement function, also called motor function.

First, we do a laminectomy. Neurosurgeons remove one or more sides of the back arches of a spinal bone (vertebra). We can then reach the spinal cord or spinal nerve roots that need repair.

Next, we remove some of the fatty mass and free up the spinal cord. We close the defect where the fat enters the baby’s spinal canal.