Lumbosacral lipoma: traction bipolar coagulation dissection

Abstract

Objective. To analyze the technique of traction bipolar coagulation dissection (strip technique), to assess its effectiveness and safety in surgery for removal of lumbosacral lipomas of various types. Material and Methods. The study involved 39 patients (the follow-up period was 1 year) operated on for removal of lumbosacral lipoma using the method of traction bipolar coagulation dissection. The 3D models of lumbosacral lipomas before and after surgery were created based on neuroimaging data, the neurological status before and after surgery was assessed using the SBNS scale, and the results of intraoperative neurophysiological monitoring were analyzed. Results. A decrease in the volume of lumbosacral lipomas by 95.0 % was achieved in all patients, the volume after surgery was less than 1 cm3 (p < 0.01). Positive dynamics of neurologic status according to the SBNS scale was observed in 94.9 % of patients (p < 0.01). Motor evoked potentials remained unchanged throughout surgery in most patients. No false negative results of intraoperative neurophysiological monitoring were obtained. Conclusion. Traction bipolar coagulation dissection is an effective and safe method of surgical treatment of lumbosacral lipomas allowing the safest and most complete removal of lipomatous tissue, as well as improving the functional state of patients.

Keywords

• traction bipolar coagulation dissection
• strip technique
• lumbosacral lipoma
• tethered spinal cord syndrome