Cervical intramedullary spinal cord lipoma.

Background: Intramedullary, nondysraphic, spinal cord lipomas are rare and account for less than 1% of all spinal cord lesions. Symptoms typically consist of a progressive myelopathy associated with increasing degrees of paralysis (e.g., quadriparesis/plegia, paraparesis/plegia).

Case Description: A 39-year-old male, without a history of spinal dysraphism, presented with a progressive spastic quadriparesis. This was attributed to magnetic resonance-documented large intramedullary cervical lipoma. Following partial intramedullary surgical debulking of the lesion, the patient neurologically improved.

Conclusion: Partial debulking of a cervical intramedullary lipoma in a patient who originally presented with a severe quadriparesis resulted in significant neurological improvement. Notably, utilization of intraoperative ultrasonography, CO2 laser, and both motor evoked and somatosensory evoked potentials can be helpful during the removal of such lipomas.