Lipomeningocele is a rare neural tube defect with an incidence of 0.3 to 0.6 per 10,000 live births. It occurs when part of the spinal cord protrudes from the spinal column and forms a sac under the skin. Because the spinal cord does not close completely, the nerves get attached to the tissues and get damaged as the child develops due to undue stretching of the spinal cord resulting in impairment of the blood supply to the cord. To prevent subsequent neurological, urological and orthopedic deterioration timely surgical removal of the lipoma with detethering of the cord under general anesthesia is very important. The considerations, in this case, were a pediatric age group, prone position, neuromuscular monitoring during detethering and bleeding. This was a case of a 1-year old child undergoing lipomeningocele excision with detethering of cord under TIVA.
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