RESUMO
A 40-year-old female patient who had tethered spinal cord with intraspinal lipoma and intractable pain of the lower leg and foot is reported. The pain started 5 years ago and exaggerated recently. A pea-size mass had been noted since birth at sacral region, which was excised 2 months prior to admission at the other clinic. Neurological examination revealed diffuse muscular wasting of the left foot, especially the sole, hypesthesia of the left sole with dysesthesia, bilaterally increased knee jerks, and absent left ankle jerk. The patient underwent L5 laminectomy, subtotal removal of extradural, intradural and intramedually lipoma with dural repair, and dorsal rhizotomy of ipsilateral L5 and S1 roots. At surgery, the neural elements were untethered with mass removal, adhesiolysis, and division of thickened arachnoid septum. The pain improved much after and was tolerable with some analgesics.