Therapy 3 (Minimal Spinal Dysraphism)

turu_27a_n.jpg and turu_27b_n.jpg: Operative findings in a 2-month-old girl in whom due to a subcutaneous lumbosacral lipoma a minimal spinal dysraphism was suspected, and corresponding work-up examinations were performed. turu_27a_n.jpg: The dura is now opened. A small hook retracts carefully a piece of tissue which is lobulated on section. turu_27a_n.jpg and figure 5: The diagnosis is a lipoma of which the part on the left side in the picture corresponds to the subcutaneous lipoma, and the part localized on the right side corresponds to the intraspinal part ( turu_27b_n.jpg). The picture clearly illustrates the tethering of the conus by the lipoma stalk and the part of lipoma connected to the conus; on the right side and caudally of this lipoma part, the cauda equina is visible, and underneath on the left side and cranially the conus. By the resection the tethering is relieved, and with an extension plasty of the dura the conus is also surrounded by cerebrospinal fluid on its dorsal side, avoiding recurrence of tethering.