Spinal Dysraphism with Spinal Lipoma

Abstract

“Spinal dysraphism” is a development abnormality of the neuro-axis. The symptoms usually occur in the childhood, but rarely develop in the adulthood. We reported an adultcase.
The patient, a sixty-three years old male, complained of gaid disturbance that had begun at the age of twenty-five years and had developed very slowly. On admission, he could scarecely walk with two canes. The lege were analgesic, and paraplegic below the knee. The ankle jerks were absent. The feet showed severe “cave-varus” deformities. Subcutaneous lipoma was observed on the sacrum. Metrizamide myelography revealed saddle-shaped defect at the L3-4 level. Although laminectomy from L3 to L5 wasperformed and subarachonid lipoma was removed, good reasults were not obtained.
The neural deficits of spinal dysraphism commonly occur at the age of four to six years, thereafter develop during the growth. Onsets or developments of neural deficits in an adult were rarely reported. The mechanisms of neural deficits in such lately developed cases were still unknown. Degenerative spinal stenosis accompanied with aging, relatively insidious traumas to the tethered cord, arterial sclerosis and ischemia may be concerned.