1. LIPOMYELOCELE 38 yr old male Patient with semifluctuant swelling in the Rtgluteal region since childhood . Weakness in the lower extremity on either side . MERCURY IMAGING INSTITUTE SCO 172-173 SEC 9C CHANDIGARH MERCURY IMAGING CENTRE SCO 16-17 SEC 20D CHANDIGARH

3. Spinal cord remains with in the canal .

4. IntraspinalLipoma is appreciated dorsal to the neural placodeand it communicates with the subcutis fat through dysraphic defect. Intraspinallipoma can extend to the variable level.

5. Thecal sac does not extend throught the dysraphic defect.

7. SPINA BIFIDA INTRASPINAL LIPOMA LOW LYING CORD TETHERING

8. FAT SATURATION INTRASPINAL LIPOMA COMMUNICATING WITH SUBCUTIS FAT.

9. CORONAL IMAGE CORD ON TOP OF LIPOMA NERVE ROOTS ON EITHER SIDE OF LIPOMA

11. FAT SATURATION NO THECAL SAC IN THE SUBCUTIS FAT – C/F LIPOMYELOMENGICELE SPINA BIFIDA INTRASPINAL LIPOMA WITH COMMUNICATION WITH SUBCUTIS FAT.

12. Lessons learnt Open spinal cord is referred to as neural placode. Lipoma’s are tightly adhered to the dorsal surface of the cord. Differentiate lipomyelomeningocele from the lipomyelocele. Define the location of lipoma properly. Identify the nerve roots as they exit from the ventral surface of the placode- If not identifed properly may be interuppted at time of surgical intervention.