Spinal cord tethered by lipoma

[JG107]

Thank you for taking my question.  I am a 50 yr old female, about 30 lbs overweight with high cholesterol, but otherwise in good health (I am now exercising 1 hr/day, and successfully reducing cholesterol with herbal medication).  Subsequent to a MVC in 1973, I developed left leg numbness and muscle atrophy. A laminectomy was performed in 1978 at L2/3 and L3/4 to provide space to the existing lipoma, which was just over 2 cm with an extension to L5/S1.  A recent MRI report described a collection of fat extending from L2/3 to L5 over a length of 6.6 cm, with a maximum AP diameter of 19 mm and maximal transverse diameter of 15 mm.  It causes some flattening of the posterior aspect of the cord, most marked behind L3.  The conus tip extends to L4.  There is also a large arachnoid cyst in the left posterolateral aspect of the spinal canal, extending from L4/5 to S1/2 and is 4.7 cm long.  Its maximal AP and transverse dimensions are 2.7 and 1.5 cm.  It caused considerable flattening of the left posterolateral aspect of the thecal sac and some mass effect on the left L5 nerve root.  Spinal canal and foraminal dimensions are well maintained.  Would you please briefly discuss risks and benefits of micro-surgery to remove the lipoma and cyst?   Any idea of why the lipoma and cyst grew or how I can prevent further growth?  What is the likelihood of retethering?  Is there anything else I ought to consider?  Thank you very much for your time and trouble. JS
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[JG107]

I don't know what type of cyst it is.
I realize that most de-tethering surgeries result in retethering, however, my question to the site's surgeon responders was specifically about my situation, which is somewhat unusual.
I don't know if the tethering is congenital or from the MVC, however, as there were no previously related symptoms, I suspect that it is due to the trauma.  Whichever it may be, I'm not clear on what difference it makes to outcome.

[selmaS]

Hi...I am curious as to what type of cyst u have...and from what I was told about my tethered cord is a cyst will be present.

As for re- tethering it is possible u may have to have this surgery again as ne injury to the spine or scar tissue can cause this to happen.

Be sure u r dealing with a NS that specializes with this condition as it can be a diff one to bounce back from.....

I have not had surgery yet, as I had another issue my drs felt should be done first.

Do u know is ur issue congenital or from the MVA trauma?

"selma"