Dorsal epidural spinal lipomatosis

Chibbaro, Salvatore; Mirone, Giuseppe; Nouri, Mannan; Emidio, P. Di; Polívka, Martin; Marsella, M.; George, B

doi:10.1136/bcr.09.2010.3365

Cited by 7 publications

(13 citation statements)

References 12 publications

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“…Spinal fatty deposits are rare conditions defined by location and pathologic features that go from lipomyelomeningoceles, intradural spinal lipomas or spinal angiolipomas, to epidural lipomatosis [4] . SEL is the result of an epidural adipose tissue overgrowth within the spinal canal.…”

Section: Discussionmentioning

confidence: 99%

“…SEL is the result of an epidural adipose tissue overgrowth within the spinal canal. Despite affecting man more often, lumbar localized deposits tend to appear more commonly in woman [4] . Exogenous steroid use represents more than half of the cases and results from a chronic steroids usage in high doses.…”

Section: Discussionmentioning

confidence: 99%

“…Conservative treatment is an option in the cases where the causative factor may be stopped. However, most of the cases end up developing neurological symptoms and surgical management is required [1,4] . In this paper, the authors report a case of dorsal lipomatosis in a patient with pan hypopituitarism chronically submitted to a high dose of exogenous steroids that developed progressive myelopathic symptoms and required surgical treatment.…”

Section: Introductionmentioning

confidence: 99%

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Thoracic epidural lipomatosis as a cause of progressive myelopathy: A case report

Lopes¹,

Relvas-Silva²,

Duarte-Silva³

et al. 2023

Int. J. Case Rep. Orthop.

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A 57-year-old patient diagnosed with panhypopituitarism, chronically managed with steroids, developed a dorsal lipomatosis combined with multiple vertebral fractures, leading to progressive dorsal myelopathy. Surgical management was necessary, and the follow-up showed significant improvements in symptoms and quality of life. Conclusion: Spinal epidural lipomatosis is a condition resulting from excessive fat deposit in epidural space. Patients can be asymptomatic or complain from myelopathic or radicular symptoms. Many etiologies are possible and exogenous steroids excess is one of the most frequent, having a predilection for male sex and thoracic spine. Surgical management is frequently necessary and may provide good results.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Thoracic epidural lipomatosis as a cause of progressive myelopathy: A case report

Lopes¹,

Relvas-Silva²,

Duarte-Silva³

et al. 2023

Int. J. Case Rep. Orthop.

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“…[ 1 ] The vast majority of lumbar spinal stenosis results from degenerative changes including: disc herniation, hypertrophy of the facet joints and the ligamentum flavum, osteophytosis, and spondylolisthesis. [ 2 ] Recently, an uncommon cause of spinal canal stenosis was reported and investigated, which is, namely, spinal epidural lipomatosis (SEL), [ 3 , 4 ] or more specifically, lumbar epidural lipomatosis (LEL). [ 5 – 7 ] LEL is characterized by an excessive deposit of normal unencapsulated adipose tissue in the epidural space causing compression of the nerve roots and the spinal cord.…”

Section: Introductionmentioning

confidence: 99%

An investigation and validation of CT scan in detection of spinal epidural adipose tissue

Chen

et al. 2020

Medicine

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To investigate the accuracy of computed tomography (CT) in evaluating spinal epidural adipose tissue compared to magnetic resonance imaging (MRI). CT scan images and matched magnetic resonance images of total 368 patients between July 2014 and July 2016 were evaluated. Hounsfield units (HU) of epidural fat (EF), dural sac (DuS), ligamentum flavum, bone of facet joints, and paraspinal muscles were measured for comparison. Anteroposterior diameter of the EF, anteroposterior diameter of the DuS, transverse diameter of the DuS, cross-sectional area of the EF, and cross-sectional area of the DuS were measured at each disc level from L1–2 to L5–S1. Fat tissue showed exclusive negative HU significantly different from all other periphery tissues. Pearson correlation coefficient analyses showed significant positive correlations between CT and MRI measurements; Bland–Altman plots also depicted satisfied agreement. Overgrowth of spinal EF was more commonly found at L2–3 and L3–4 levels in present study, and body weight, age, and gender were significantly associated with amounts of EF both on CT and MRI. The CT scan is a satisfied alternative of MRI for the evaluation of spinal epidural adipose tissue.

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“…pinal epidural lipomatosis (SEL) is a rare condition often associated with glucocorticoid excess and obesity in which there is an overgrowth of adipose tissue within the epidural space of the spinal canal. [1][2][3] This can cause spinal cord and nerve root compression, leading to symptoms such as back pain, radiculopathy, myelopathy, and cauda equina syndrome. 2,4 We report a case of thoracolumbar epidural lipomatosis treated successfully with continuous hemilaminectomies from T3-L5 performed through 5 small incisions using the Caspar Micro Lumbar Discectomy system (Aesculap Spine).…”

mentioning

confidence: 99%

Extensive Symptomatic Thoracolumbar Epidural Lipomatosis Treated With Minimally Invasive Hemilaminectomies: Technical Case Report

Fuentes

Housley

Starling

et al. 2022

Operative Neurosurgery

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BACKGROUND AND IMPORTANCE: Spinal epidural lipomatosis is a rare condition commonly associated with chronic corticosteroid use and obesity that involves deposition of adipose tissue in the epidural space of the spinal canal. This accumulation of adipose tissue may cause compression of the spinal cord and/or nerve roots and result in compressive symptoms such as myelopathy or radiculopathy. Spinal involvement is usually confined to either the thoracic or lumbar spine but can infrequently affect both regions. Depending on pre-existing conditions, treatment options include weight loss and discontinuation of exogenous steroid use, both of which have been shown to be effective therapeutic methods. Surgical decompression may be useful for appropriately selected patients in whom conservative therapy has failed or who experience acute neurological deterioration, although this is rarely indicated. CLINICAL PRESENTATION: In this study, we describe a patient receiving long-term corticosteroid therapy who presented with symptomatic epidural lipomatosis that involved the thoracic and lumbar spine. She was treated with decompression by continuous T3-L5 hemilaminectomies performed through 5 small incisions of alternating laterality. After surgery, the patient experienced clinical improvement and was able to return to her baseline. CONCLUSION: We illustrate a successful spinal decompression of extensive epidural lipomatosis through a less-invasive surgical approach using several small incisions to accomplish uninterrupted hemilaminectomies. This alternative approach to a standard continuous incision can be considered in cases of extensive spinal epidural lipomatosis in patients with multiple medical comorbidities in whom wound healing is believed to be an issue and for whom minimizing blood loss is crucial.

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Dorsal epidural spinal lipomatosis

Cited by 7 publications

References 12 publications

Thoracic epidural lipomatosis as a cause of progressive myelopathy: A case report

Thoracic epidural lipomatosis as a cause of progressive myelopathy: A case report

An investigation and validation of CT scan in detection of spinal epidural adipose tissue

Extensive Symptomatic Thoracolumbar Epidural Lipomatosis Treated With Minimally Invasive Hemilaminectomies: Technical Case Report

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