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<p><b>OBJECTIVE</b>To investigate the methods and techniques of surgical treatment of lipomyelomeningocele in children.</p><p><b>METHODS</b>From January 2004 to March 2007, twenty-five children aged from 2 months to 6 years with lipomyelomeningocele were operated on. Magnetic resonance imaging and electromyogram had been conducted to all the patients. The operation was composed of subtotal excision of lipomas, suture of spinal pia mater and resection of terminal filum. The results of treatment were evaluated by Hoffman's functional grading scheme for lipomyelomeningocele.</p><p><b>RESULTS</b>After operation, all the patients recovered and were released from hospital. No complications, including cerebrospinal fluid leakage and infection occurred. During the follow-up of 1 - 4 years, 18 asymptomatic patients' neurological function were normal and there was no deterioration, 7 symptomatic patients improved. Among the 7 patients, 4 patients had higher function grades compared with their preoperative assessments, and the other stayed in the same grades but with symptoms improved. Magnetic resonance imaging showed no tethered cord in all the patients postoperatively.</p><p><b>CONCLUSIONS</b>For lipomyelomeningocele, early operation should be performed to prevent the development of neurological defect. It is safe and effective to adopt subtotal excision of lipomas, suture of spinal pia mater, and resection of terminal filum.</p>

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Objective To investigate the diagnosis, and the treatment methods and techniques of cervical myelomeningocele. Methods Nine patients with cervical myelomeningocele, including 5boys and 4 girls, were chosen and received treatment from January 2001 to December 2006. Their ages ranged from 9 d to 5 y. All patients underwent neurological and radiological examinations. One of the 9patients had mild unilateral arm weakness and the others had neurological intact. Of these 9 patients, 4had other associated neurological or orthopedic abnormalities, including mild ventriculomegaly in 2,cervical diastematomyelia in 1 and sacral spina bifida occulta in 1. Surgical excision of the sac and intradural exploration of the sac were performed to release any potential adhesion bands. Results No complications, including cerebrospinal fluid leakage or infection were found after operation. During the follow-up of 1-7y (mean 3.9 y), no cases suffered from any aggravation of the nervous symptoms. Nopatients with neurological intact had a noted neurologic deficit. One patient with left arm weakness got improvement following surgery and 2 with mild ventriculomegaly had normal cerebral ventricle.Conclusion Cervical myelomeningocele with clinical characteristics is a less common congenital spinal anomaly. MRI can identify the internal structures and associated anomalies. The management strategies of cervical myelomeningocele are early surgical treatment with standard microneurosurgicaltechniques to prevent the development of neurological defect. It is a safe and effective method to select and adopt surgery excision of lesions with intradural exploration of the sac to release any potential adhesion bands.