Lipoma on spine

[mammie6]

I had an MRI done to see if this fatty tumor on spine is pressing on nerves and causing back pain. The radiologist that looked at my films and wrote up the report said that i have disc desiccation involving predominatly the mid thoracic segments extending down to approximately T8-T9. Subtle contour abnormality is seen in the T8-T9 disc which is on the left side and results in mild broad-based asymetric effacement of the left anterior aspect of the thecal sac and could indicate a small protrusion of the disc.  My "lipoma" according to my family doctor is located right at the same area. My family doctor called the radiologist back and had him relook at my films to see if he saw any fatty tumors on the films and he said yes, there is a lipoma about 6 cm wide right at the T-8 T-9 that maybe pressing on the nerves? So, my family doctor is setting me up with a general surgeon to have it removed. I'm confused, I don't know what any of this means. Should i see a neurologist and get a second opinion? I have insurance and i believe i don't need a referral.

[Lama Chahine, MD]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what the best strategy of management of your lipoma is. However I will try to provide you with some useful information.

The spinal cord is lined with a tissue called dura (and some other tissues) and is contained within a column of bones called the spinal column. It is not clear from the above description if you have a diagnosis of lipoma, and if so, whether or not the lipoma is intradural, meaning within the column of bones and within the lining of the cord, or outside of the spinal column all together.

Disks are jelly like substances that cushion the space between the bones of the spinal column. With repetitive trauma (such as in athletes) or with age, the disk loses some of its water content, this is called dessication. The disc may then protrude, or herniate between the two bones and press on the spinal cord or on the nerve roots as they exit the spine. It sounds like you have some structure (either a lipoma or a herniated disc), touching but not compressing the spinal cord. However, it also sounds like ? another radiologist thought this was a lipoma, so this is unclear, and it is difficult for me to comment further.

Whether the structure is a lipoma or a herniated disc, or whether you have both a known lipoma and in addition a herniated disc, surgery may not necessarily be necessary. You would benefit from evaluation by a spine surgeon if there is concern for a lipoma or herniated disc leading to pressure on the spine or nerve roots.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

[00000PITA]

I to have a lipoma on my lower spine. It appears to get bigger and some times even smaller. It does create a numbing in my legs. I went to see my family Dr who ordered a CT scan.  I then took that to a surgeon who wanted a MRI as the lipoma was migrating deeper and he thought around some nerves. I am set for the MRI in a month and a half then we will decide about surgery. I went from chopping loads of wood up to three months ago to splitting an armful or two with great pain. I live on muscle relaxants and Tylenol 3 pills. I just want to get back to where I was 5 months ago. Keep working on it because it  is to easy to diagnose as a fatty growth with no implications.