Lumbosacral spina bifida associated with an intraspinal lipoma

Spina bifida is a congenital malformation which occurs during the first weeks after conception. The association with intraspinal tumours, usually lipomas, is well known. During evaluation of back pain, we observed a case of occult spina bifida associated with extra- and intradural lipoma. Simultaneously the patient exhibited cutaneous, orthopedic and neurological signs. The clinical symptoms of lipoma are due to compression and elongation of the spinal cord causing tethered cord syndrome. The onset of neurological symptoms usually occurs in childhood. Late occurrences in adults are often associated with sphincter problems. CT scan and, in particular, magnetic resonance imaging (MRI) provide good visualization of intraspinal lipoma. Treatment is surgical.