Therapeutic methods for lipomyelomeningocele: literature review

Lipomyelomeningocele is a congenital malformation in which the neural plate lies outside the spinal canal. Patients younger than 6 months of age are neurologically asymptomatic. However, if not diagnosed, the disease evolves with deterioration of bowel and bladder functions and, later, with motor deficits (paralysis) and loss of sensation. Accordingly, a literature review was developed about the therapeutic methods that enable a better quality of life and prevent or control disease progression. Objectives: This literature review aims to elucidate leading updates in the literature regarding the therapy for lipomyelomeningocele, a rare form of spinal dysraphism. Methods: Searches were performed in the LILACS e PubMed database and in the health descriptors (DeCs/MeSH), to establish the descriptors. Of the 6,292 articles found, 20 were selected, since only they presented relevant information about this topic. Results: From reading the articles, it was concluded that surgery is the recommended treatment for cases of lipomyelomeningocele. The main goal of surgery is to prevent future damage or further neurological deterioration and also to preserve or improve current neurological function. The widespread use of advanced prenatal ultrasonography can show neural development and suggest congenital malformations and progressive neurological deterioration. Conclusions: Although surgery is the best treatment, it may also be accompanied by outcomes such as meningitis, CSF leakage, neurological deterioration as a result of tethered cord or secondary to nerve injury, and incomplete healing or wound breakdown. Prenatal ultrasound is necessary to identify the malformation and support early diagnosis of lipomyelomeningocele and may open doors for future care and treatment.