Lumbar cystic epidural lipomatosis with mass effect. Report of an unusual case

Spinal Epidural Lipomatosis: A Comprehensive Review

“…Minimally invasive procedures are an effective option in treating SEL when conservative measures fail. [65][66][67][68] Endoscopic removal of fat can be performed similarly to common endoscopic spinal surgeries such as removing a herniated nucleus pulposus. 66 Minimally invasive spinal surgeries are 66 preferred due to lower postoperative pain, shorter rehabilitation time, and less cosmetic damage when compared to more invasive surgeries.…”

“…65 In 2020 Roberti et al presented a novel case where minimally invasive tubular laminectomy was performed to drain and remove a cystic epidural lipomatosis. 67 The male patient presented with bilateral lower extremity weakness and bilateral sciatica. MRI scans indicated dural sac compression by what appeared to be a cystic mass at L4-L5 (Figure 3).…”

“…MRI scans indicated dural sac compression by what appeared to be a cystic mass at L4-L5 (Figure 3). 67 The patient elected to be treated with a minimally invasive tubular laminectomy with drainage and removal of the cystic mass. The authors reported a fatty cystic lesion with no clear capsule that was filled with yellow fluid.…”

“…The patient reported no complications six months post-operation. 67 SURGICAL MANAGEMENT Large-scale, controlled studies comparing the efficacies of conservative treatment, minimally invasive surgical treatment, and open surgical treatments of spinal epidural lipomatosis have not been conducted due to the condition's rarity. However, many cases showing the effectiveness of surgical management of SEL have been reported, making surgical intervention a relevant option in the treatment.…”

“…56 In 2016, Ferlic et al published an analysis of 22 patientreported outcomes of surgical spinal decompression as a treatment for MRI confirmed lumbar SEL. 56 The authors 67 used the Core Outcome Measures Index (COMI) to assess pre-and postoperative pain, function, well-being, quality of life (QOL), work disability, and social disability reported by the patients. After the 3-month postoperative COMI questionnaires, the authors reported a significant improvement (p<.05) in mean (n=22) scores for overall COMI, leg pain, and back pain.…”