Thoracic intradural extramedullary lipomas. Report of three cases and review of the literature

Background. Indication for surgery and the surgical strategy for treatment of spinal intradural lipomas arc still discussed controversially. Among spi nal lipomas the cervicothoracic region is rarely affected, We report on our experience with spinal decompression for the treatment of three intradural thoracic lipomas. Findings. Three adult patients with extramedullary intradural lipomas of th e thoracic spinal cord demonstrated progressive neurological symptoms and s igns without evidence of growth of the lipoma. All patients underwent surge ry with decompression of the affected spinal levels. No attempt was made to reduce the size of the lipomas. Postoperatively, each patient demonstrated significant clinical improvement, Interpretation. Attempts to remove lipomas are associated with significant risks of surgical morbidity. Lipomas are hamartomas which change their size according to alterations of body fat. Therefore, decompression of the affe cted spinal levels is sufficient to achieve significant neurological improv ement.