Long-term neurological stability after decompression with duraplasty without resection of a non-dysraphic thoracic spinal lipoma: a 30-year follow-up case report.

Intradural spinal lipomas without associated dysraphism are rare, and the optimal surgical strategy remains controversial, particularly for thoracic lesions strongly adhered to neural structures. A 17-year-old female presented with progressive spastic gait and sensory disturbances in the lower extremities that developed during pregnancy. Magnetic resonance imaging showed an intradural lesion at the T5-T8 level consistent with a spinal lipoma. Because of the absence of a clear dissection plane and strong adhesion to neural elements, tumor resection was not attempted. Instead, decompression and duraplasty were performed. The patient showed gradual neurological improvement and was discharged 5 weeks postoperatively. At the 30-year follow-up, the patient remained neurologically stable with no evidence of tumor progression. Decompression without tumor resection may provide favorable long-term outcomes in selected cases of non-dysraphic intradural spinal lipomas with strong adhesion to neural structures.