Developing a biomarker for children with spinal lipoma

  • Research type

    Research Study

  • Full title

    Developing a biomarker for monitoring clinical outcome in children with spinal lipoma

  • IRAS ID

    171021

  • Contact name

    Andrew Copp

  • Contact email

    a.copp@ucl.ac.uk

  • Sponsor organisation

    Great Ormond Street Hospital & Institute of Child Health

  • Duration of Study in the UK

    2 years, 0 months, 0 days

  • Research summary

    ‘Spinal lipoma’ describes a group of childhood conditions in which fatty tissue (lipoma) is present from before birth, stuck to the lower end of the spinal cord. This condition occurs once in every 4,000 pregnancies and can lead to progressive disability. Weakness or pain and disorders of urination are commonly encountered because of gradual stretching of the spinal cord during growth. Surgical ‘untethering’ operations are the main treatment. However, only a proportion of children with spinal lipoma deteriorate and need surgery. Others remain healthy and need no operation. Therefore, surgeons face a dilemma: whether to operate on all children when they are young – and subject many to an unnecessary operation – or to operate later, only if symptoms appear. Delaying the operation in children who deteriorate might mean a worse outcome than if they were operated upon earlier in life.

    A simple blood or urine test is needed that could be performed on very young children, when they are first diagnosed with spinal lipoma. The test would guide the doctor as to whether the child is at high risk of deterioration, and so needs early surgery, or is at low risk in which case surgery could be delayed and perhaps avoided altogether. Our idea is that fat molecules may leave the spinal fluid and enter the bloodstream and urine of children with high risk spinal lipomas. These molecules will be detected using a procedure called ‘mass spectrometry’ in which all the different fat molecules are separated out, to provide a ‘fingerprint’ for that particular patient. By comparing children who deteriorate with those who stay healthy, we hope to identify a fingerprint that can predict whether a particular child is likely to deteriorate or not. This project could significantly improve how children with spinal lipoma are managed clinically in the future.

  • REC name

    West Midlands - Edgbaston Research Ethics Committee

  • REC reference

    15/WM/0249

  • Date of REC Opinion

    30 Jul 2015

  • REC opinion

    Further Information Favourable Opinion