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Spinal Lipoma is a rare condition and when associated with Neural Tube defects, can pose a formidable. challenge to the treating team. It is anociated with large number of other system abnormalities, like urogenital system, musculo skeletal and GI system. Hence needs detail examination, accurate diagnosis and skillful management, to get optional result.
To my surprise only few paper are published from Indian subcontent, over last 3-4 decades, and no book is published on this topic in the world. We always follow what Europe and America do. But we must do something which others can read and follow us as well. In this connection, I must mention, two years back I wrote a book on Split Cord Malformation in which, I have the good amount of experience. In such a case why not others follow us. And learn from our experience?
During my work at AIIMS, I started operating conus lipoma from 1986-87, when I was associate Professor. My professor never operates such cases of Neural Tube Defect. I was in Pediatric Surgery in 1976 for a periods 6 months. SR of Pediatric Surgery used to operate such. NTD cases and hardly ever a consultant operated such cases. No investigation were done. As there was N no CT or MRI scans, available those days.
Some experience I had given me confidence to operate Pediatric Neurosurgery. At AIIMs there is long waiting period for everything. These kids had no scope for early admission as SAH and brain tumor cases were priority. I used to see 250-300 NTD case in a year of which only 30-35% used to get admitted and operated. Thus over a 35 year period I operated over 4000 spinal dysraphism of which 30% MMC, 30% SCM, 20% lipoma and 15-20% combinations of pathology. Thus I operated over 400 cases of Spinal Lipoma is 32 year period from 1985 through 2017. The experience I got was by and large due to apathy operating for these small kids, what a pity!
This book being about Indias experience in a subject in which not many people have worked in the world. More importantly SD patients are decreasing all other the world and Neuro Surgeon or even pediatric Neuro Surgeons are increasing in number. About 6months back I approach many of our friends and collegue to contribute for this book. I know how difficult to write a book or even a chapter. I thank all contributors profusely for effort and dedication. This will go in a long way to educate our residents in India and also friends outside.