Background: Lipomyelomeningocele is a spectrum of closed neural tube defects that represents a challenge to neurosurgeons all over the world especially when associated with inherent tethered cord causing neurological deficit
Objectives: we try to define the rationale of managing lipomeningomyelocele according to our experience at the Neurosurgery Department of Benha University Hospital between January 2013 and January 2022,
Patients and methods: retrospective study was carried out on 56 patients with lipomeningiomyelocele divided into 3 groups
• Group A: Patients without neurological or urological deterioration who were treated conservatively include 20 patients
• Group B: Patients without neurological or urological deterioration who underwent prophylactic early surgery include 16 patients
• Group C: Patients who were treated surgically after the onset of neurological or urological deterioration include 20 patients
Results: we noticed that 9 of the patients managed conservatively (45 %) continue to to deteriorate while 7 of the patients managed surgically earlier than the appearance of deterioration (43.8%) continue to deteriorate with no statistically significant difference between the two groups in comparable follow up periods
Conclusions: we support the option of expectant treatment for asymptomatic patients as it carries nearly the same probability of developing deterioration in either nervous or urinary condition and surgery when deterioration started could stop this deterioration although could not reverse it.
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