Long-term neurological stability after decompression with duraplasty without resection of a non-dysraphic thoracic spinal lipoma: a 30-year follow-up case report

Abstract

Abstract Intradural spinal lipomas without associated dysraphism are rare, and the optimal surgical strategy remains controversial, particularly for thoracic lesions strongly adhered to neural structures. A 17-year-old female presented with progressive spastic gait and sensory disturbances in the lower extremities that developed during pregnancy. Magnetic resonance imaging showed an intradural lesion at the T5–T8 level consistent with a spinal lipoma. Because of the absence of a clear dissection plane and strong adhesion to neural elements, tumor resection was not attempted. Instead, decompression and duraplasty were performed. The patient showed gradual neurological improvement and was discharged 5 weeks postoperatively. At the 30-year follow-up, the patient remained neurologically stable with no evidence of tumor progression. Decompression without tumor resection may provide favorable long-term outcomes in selected cases of non-dysraphic intradural spinal lipomas with strong adhesion to neural structures.