Surgical Treatment of Lipomatosis of Nerve: A Systematic Review
BACKGROUND: Lipomatosis of nerve (LN) is one part of spectrum of adipose lesions of nerve. Nerve-territory overgrowth is present in approximately 62% of cases. Given the wide variability in published reports, there is substantial need to understand the results of surgical treatment and outcomes in this disorder. MATERIALS AND METHODS: Raw data from the published systematic review of LN were used for this analysis. PubMed and Google Scholar databases were also screened for any additional papers. The cases were sorted into 2 groups: 1) definite LN cases 2) probable LN cases (lacked definite proof of LN diagnosis). For statistical analysis, p-value <0.05 was considered statistically significant. RESULTS: The total number of 486 definite and 160 probable LN cases (646 cases combined) was included for analysis. The procedure the most commonly performed was nerve decompression in both definite (n=104; 21.4%) and combined definite and probable LN groups (n=107; 16.6%). Improvement of symptoms was most often reported after nerve decompression (n=52). A soft tissue debulking procedure had the highest association with improvement (OR 144.6, CI: 13.8-1516.2, p<0.001) in the definite LN group. CONCLUSIONS: Treatment options for LN ranges widely, however notable consistencies exist. The most conservative procedure involving nerve decompression was the most commonly performed procedure and with reported good outcomes. In contrast, worsening of symptoms was most commonly reported when nerve resection was performed. All treatment modalities were associated with improvement compared to no treatment. Diagnostic biopsy should be avoided.
Marek, T., Spinner, R., Syal, A., Wahood, W., & Mahan, M. (2019). Surgical Treatment of Lipomatosis of Nerve: A Systematic Review. World Neurosurgery. https://doi.org/10.1016/j.wneu.2019.04.110