We reviewed the radiological,
and clinical data from 40 patients diagnosed with lipomyelomeningocoele,
who were followed up and mostly treated by the department of neurosurgery in our institution.
6 of these were excluded from the study because the medical notes and radiological imaging studies were not available to us which reduced the overall number of analyzed cases to 34.
The MRI protocol we used comprised; sagital (T1,
T2,
Stir),
coronal (T1) an axial (T1,
T2) sequences.
For the 34 patients for whom MRI reports were available we used the Pang modified classification to anatomically classify each patient's lipoma and determine the diameter of the lipoma,
we did this using the largest measurement in any axis.
From reviewing each patients recorded symptoms we calculated the Necker Score for each patient,
we also recorded the sex of each patient.
We then compared these variables to see if there was any correlation between them.
Results:
Although the literature refers to a predominance of the condition in the female sex,
our case series contained 22 men and 18 women,
aged between 2 and 47 years old.
Using the Pang classification we determined that within our case series there were a total of 8 dorsal lipomas,
8 caudal or terminal lipomas,
10 transitional,
8 chaotic lipomas and 6 patients who were not classifiable because they came from different centers or the information was not available in their clinical history,
all of the later were females.
Of the Dorsal Lipomas 5 were lumbar and 3 lumbosacral,
their sizes ranged from 20mm to 120mm and their Necker scores from 8 to 18.
Of these 8 cases 4 were male and 4 female
2 of the Caudal or Terminal Lipomas were Lumbar the other 6 sacral,
sizes ranged from 20 to 58mm and Necker scores from 9 to 18.
Of these 8 patients 6 were Male and 2 Female
In the Transitional Lipomas 4 where Lumbosacral and 6 Sacral,
with diameters ranging from 33 to 130mm and Necker scores of between 11 and 18.
9 of these patients were male and 1 female.
Of the 8 Chaotic Lipomas 3 were Lumbar 2 Lumbo Sacral and 3 Sacral.
Their diameters ranged from 37 to 90mm and their Necker scores from 9 to 19.
Of this group 3 were Male and 5 female.
Of these 34 cases 6 did not have a recorded diameter within their medical notes prior to surgery and the presurgical studies were not available.
Once all the data was collected we collated it into a scatter graph to look for a correlation between our variables.
We also undertook statistical analysis to determine whether the severity of symptoms was worse in females compared to males
As can be seen on our scatter graph ( Fig. 7 ) we compared the variables of diameter,
symptom severity (Necker Score) and Anatomical location,
to see if there was any correlation.
Given our sample sizes it would not be possible to accurately determine whether there is a correlation between symptoms or size of lipoma in any given anatomical location.
However it was clear that there was no correlation between the diameter of Lipoma and symptom severity.
In reviewing our data we did notice a trend that irrespective of the size of the lipoma,
the severity of symptoms appeared to be worse in females over males.
However using an unpaired t-test to compare the two sets of data we found the p value to be 0.8875 and therefore there was no significant difference between the 2 groups.
However it must be stressed that the sample sizes of both groups was very small (n=12 and n=22 for females and males respectively) and therefore we cannot definitively say that there is no significant difference between the severity of symptoms in the 2 sexes.