Epidemiology of Spinal Lipoma in Children

Incidence and Prevalence

• 0.06% to 0.25% in general population: The incidence of spinal lipomas in international medical literature shows considerable variation due to population demographics, lipoma definitions, and diagnostic criteria. Nonetheless, consensus within the medical community suggests that spinal lipomas are infrequent, with incidence rates ranging from 0.06% to 0.25% in the general population (11).
• Up to 1.5% in children: Among children, the incidence may be as high as 1.5% (11).

Age Distribution

• Congenital disorder with variable age of presentation: The diagnosis of spinal lipoma is most commonly made in infancy, based on external swelling, appendage, or hemangioma of the lumbosacral region (cutaneous stigmata of spinal dysraphism). Spinal lipomas can also be detected during antenatal ultrasonographical screening. In other cases, external signs may be absent and spinal lipoma may be diagnosed only following the appearance of motor or urinary symptoms. The growing accessibility to MRI has led to earlier diagnoses.

Sex Predilection

• Female 1.6 times that of male: Most series report a female predominance, with a female-to-male ratio of 1.6 to 1 (9,11,12). This differs significantly from the gender distribution in meningomyelocele, which displays an equal ratio (9), and for spina bifida occulta in general, where a higher male predominance is reported (13).

Geographic Distribution

• Unknown: Accurate data on the global incidence variations of spinal lipomas is sparse.

Risk Factors

While risk factors for open neural tube defects have gained significant attention, understanding those for closed neural tube defects remains limited.

• Folate: LMM may share genetic factors with open neural tube defect in some families (3). However, McNeely and Howes recently reported no reduction in LMM prevalence after folate supplementation in Nova Scotia (14). Large prospective studies are needed to answer this question definitively.
• Genetic: Findings from the National Birth Defect Prevention Study indicate a higher prevalence of LMM among descendants of non-Hispanic white and Hispanic mothers than among non-Hispanic black mothers, which may suggest potential genetic factors in the genesis of occult neural tube defects (15). However, environmental and socioeconomic variables may have biased the study’s conclusion.

Relationships to Other Disease States and Syndromes

Spinal lipomas are most commonly present as isolated lesions. On occasion, they occur in the context of a wider malformation or syndrome, particularly syndromes involving urogenital and anorectal malformations. Syndromes linked with spinal lipomas include (12):

• Currarino syndrome (16)
• CLOVES (Congenital lipomatous overgrowth, vascular malformations, epidermal nevus, spinal/skeletal anomalies/scoliosis) syndrome (17)
• PURSM (partial urorectal septum malformations) (7)
• Bifid uterus (18)
• Duplicated vagina (18)
• Anterior sacral meningocele (19)
• Imperforate anus (20)
• Cloacal exstrophy (21)