Patients with lipomatous spina bifida have special characteristics in terms of treatment because of the close relationship with the spinal cord. Lipoma, which occurs on the dorsal side of the spinal cord, is not really a “tumor”; rather, some of the primitive cells (mesenchymal stem cells) in the spina bifida have developed incorrectly and have not allowed themselves to become complete vertebrae, but have instead regressed into non-functional fat-like tissue that grows together with the spinal cord and eventually fuses with the subcutaneous skin of the lower back. It grows together with the spinal cord and eventually fuses with the subcutaneous skin of the lower back, preventing the spinal cord from rising to its normal position as the child grows and severely stretching the end of the spinal cord. In addition, the lipoma grows and produces compression of the spinal cord, leading to gradual necrosis of the nerve cells at the end of the spinal cord and abnormal function of the urinary bowel or foot. This child has an intradural lipoma and subcutaneous lipoma, and the mass in the back is adipose tissue. Since the lipoma is close to the dorsal aspect of the spinal cord, treatment requires that the lipoma be removed as much as possible and that the spinal cord be minimized, and the procedure requires the use of an ultrasonic suction knife (CUSA) to complete the removal. This is currently seen as the most effective and least invasive surgical technique, and is particularly effective in children with large lipomas. Using CUSA as described above, a relatively complete resection of the dorsal spinal cord lipoma is possible. Postoperative MRI of the spinal cord, which was reviewed after surgery, showed that the lipoma had been largely removed.