Lipomyelomeningocele

Lipomyelomeningocele is a form of closed spinal dysraphism, a congenital condition where fatty tissue (lipoma) is attached to the spinal cord, usually in the lumbar or sacral region. This condition leads to tethered cord syndrome, where the spinal cord is abnormally stretched, causing neurological dysfunction over time. Unlike open neural tube defects, lipomyelomeningocele is covered by skin, which often delays diagnosis in infants. In Bangladesh, limited awareness and access to pediatric neuroimaging contribute to late presentation of this potentially disabling condition. 🔍 Key Characteristics Presence of a soft, fatty lump on the lower back Skin changes: dimpling, discoloration, or hair patch Associated with tethered spinal cord syndrome May be linked with orthopedic deformities or bladder/bowel issues In many rural and semi-urban areas of Bangladesh, these signs are overlooked, and children are brought for medical attention only when neurological symptoms progress. ⚠️ Symptoms of Lipomyelomeningocele Although present from birth, symptoms often progress gradually due to spinal cord tethering, and include: Weakness in lower limbs Foot deformities (clubfoot, high-arched feet) Walking difficulties or clumsiness Back pain, especially during growth spurts Loss of bladder or bowel control Scoliosis (curvature of the spine) Timely detection and intervention are crucial to prevent irreversible nerve damage. In Bangladesh, these symptoms are sometimes misinterpreted as orthopedic problems or childhood laziness. 🔬 Diagnosis A combination of clinical examination and imaging studies confirms the diagnosis: MRI of the spine – the gold standard, showing the lipoma and tethered cord Ultrasound (in newborns) – can identify spinal anomalies early X-ray – may reveal associated skeletal changes Urodynamic studies – assess bladder function in children with incontinence Dr. Nafaur Rahman utilizes advanced neuroimaging facilities at NINS and partners with pediatric radiologists to confirm complex cases of spinal dysraphism. 🛠️ Surgical Treatment of Lipomyelomeningocele The primary goal of surgery is to untether the spinal cord and remove the lipomatous tissue to prevent further neurological deterioration. 🔧 Surgical Objectives: Microsurgical excision of the lipoma Detethering of the spinal cord Preservation of neural elements Dural repair to prevent cerebrospinal fluid (CSF) leak Monitoring with intraoperative neuromonitoring (IONM) for safety “Microsurgical detethering of lipomyelomeningocele is delicate but vital. When done early, it can preserve mobility and bladder function.” — Dr. Md. Nafaur Rahman Dr. Nafaur performs this surgery with high precision under neuro-navigation and IONM, ensuring the best outcomes for children in Bangladesh. 🏥 Postoperative Care and Follow-Up After surgery, the child is monitored closely to: Ensure wound healing and absence of infection Watch for CSF leaks or pseudomeningocele Monitor neurological recovery Begin physiotherapy and rehabilitation early Schedule routine follow-up MRI to check for retethering In Bangladesh, Dr. Nafaur’s team provides comprehensive postoperative care, both at NINS and Bangladesh Paediatric Neurocare Centre, including access to urologists, orthopedists, and physiotherapists. 🌟 Prognosis and Long-Term Outcomes When detected and treated early, children with lipomyelomeningocele can: Retain or regain normal or near-normal walking ability Avoid worsening of bladder/bowel symptoms Improve posture and spinal alignment Attend regular school and engage in daily activities However, delayed surgery may result in permanent neurological impairment. Early referrals and parent education remain key in the Bangladeshi context. Challenges in Bangladesh Despite being a surgically treatable condition, lipomyelomeningocele is underrecognized in Bangladesh due to: Low awareness among general physicians and midwives Lack of routine spinal examination in neonates Limited neonatal MRI facilities in district-level hospitals Delays in referral due to financial barriers or fear of surgery Stigma and misinformation surrounding congenital deformities Dr. Nafaur is working to bridge these gaps through clinical awareness campaigns, medical training, and community engagement. 👨‍⚕️ Why Trust Dr. Md. Nafaur Rahman? 🎓 Fellowship-trained Pediatric Neurosurgeon with specialized expertise in spinal dysraphism 🏥 Leading consultant at NINS and Bangladesh Paediatric Neurocare Centre 🧠 Extensive experience in microsurgical detethering of spinal cord in children 💬 Provides holistic care with parent counseling and long-term monitoring 🏆 Successful track record in improving neurological outcomes for lipomyelomeningocele cases in Bangladesh 📞 Contact for Lipomyelomeningocele Surgery in Bangladesh Dr. Md. Nafaur Rahman Assistant Professor, Department of Pediatric Neurosurgery, NINS Chief Consultant, Bangladesh Paediatric Neurocare Centre 📱 For Serial/Appointment: 01912988182 | 01607033535 🌐 Visit: www.neurosurgeonnafaur.com