• Tomas Marek, Robert J Spinner, Akshay Syal, Waseem Wahood, and Mark A Mahan.
• Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota; First Faculty of Medicine, Charles University, Prague, Czech Republic.
• World Neurosurg. 2019 Apr 19.

BackgroundLipomatosis of nerve (LN) is one part of the 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.MethodsRaw 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 and (2) probable LN cases (lacked definite proof of LN diagnosis). For statistical analysis, P-value <0.05 was considered statistically significant.ResultsThe total number of 486 definite and 160 probable LN cases (646 cases combined) was included for analysis. The most commonly performed procedure 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 (odds ratio 144.6, 95% confidence interval: 13.8-1516.2, P <0.001) in the definite LN group.ConclusionsTreatment options for LN ranges widely, although notable consistencies exist. The most conservative procedure involving nerve decompression was the most commonly performed procedure, 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 with no treatment. Diagnostic biopsy should be avoided.Copyright © 2019 Elsevier Inc. All rights reserved.

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