Spinal Epidural Lipomatosis: A Comprehensive Review

Walker, Paul B.; Sark, Cain; Brennan, Gioe; Smith, Taylor A.; Sherman, William F.; Kaye, Alan D.

doi:10.52965/001c.25571

Cited by 27 publications

(29 citation statements)

References 75 publications

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“…12 SEL can be managed conservatively or with surgical management. 13 Conservative treatment includes weight loss and activity changes for obese patients and an endocrinological evaluation for non-obese patients. 14 A success rate of 82% was reported for patients that had conservative therapy in terms of recovering from SEL.…”

Section: Discussionmentioning

confidence: 99%

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Bilateral Lower Extremity Weakness: Spinal Epidural Lipomatosis or more?

Krishnan¹,

Stead

Oldano

et al. 2022

Orthopedic Reviews

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Spinal epidural lipomatosis is a condition that is characterized by an excess amount of epidural adipose tissue in the spinal canal. Occasionally, it can narrow the spinal canal enough to cause cord impingement resulting in neurological deficits. The authors report on a case of a 43-year-old man who presented to the emergency department with bilateral lower extremity weakness. After computed tomography imaging, he was found to have spinal lipomatosis. Since the patient had other symptoms that could not be accounted for by this diagnosis alone, he was admitted to the hospital for further neurologic workup. He eventually developed ascending areflexia which led to the diagnosis of Guillain-Barré, which was corroborated by further history that was not available initially.

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Section: Discussionmentioning

confidence: 99%

“…14 On the other hand, a laminectomy can be done to remove the excessive fat from the spinal cord. 13 A success rate of 67% was reported for patients that underwent surgery and were obese while a success rate of 77% was reported for patients that underwent surgery after having SEL due to excess steroid use. 14…”

Section: Discussionmentioning

confidence: 99%

Bilateral Lower Extremity Weakness: Spinal Epidural Lipomatosis or more?

Krishnan¹,

Stead

Oldano

et al. 2022

Orthopedic Reviews

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“…Hypertrophy of the posterior longitudinal ligament (HPLL) is a rare pathological condition that is characterised by thickening of the PLL, while spinal epidural lipomatosis (SEL) is a rare condition characterised by an overgrowth of adipose tissue in the extradural space, usually deposited in the thoracic or lumbar spine. 1 This can lead to stenosis of the central canal and compression of adjacent neural structures. First documented in 1975, the most common cause of SEL is exogenous steroid therapy, but other causes have been shown to be idiopathic, iatrogenic or due to obesity.…”

Section: Images In…mentioning

confidence: 99%

Spinal epidural lipomatosis and focal posterior longitudinal ligament hypertrophy causing severe cauda equina crowding

et al. 2022

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“…In humans, the prevalence of SEL is 1.1% to 2.5% (13,19), and it is extremely rare in veterinary medicine where only two cases have been reported (11,16). Clinical symptoms vary depending on the type, location, severity of nerves pressed by hyperplastic fat, and concurrent spinal canal stenosis, and non-specific symptoms such as back pain, lameness, and ataxia can occur due to SEL (21). In human medicine, long-term exogenous steroid therapy, Cushing syndrome, hypothyroidism, obesity, and surgery have been suggested as causes of SEL (21).…”

Section: Introductionmentioning

confidence: 99%

“…Clinical symptoms vary depending on the type, location, severity of nerves pressed by hyperplastic fat, and concurrent spinal canal stenosis, and non-specific symptoms such as back pain, lameness, and ataxia can occur due to SEL (21). In human medicine, long-term exogenous steroid therapy, Cushing syndrome, hypothyroidism, obesity, and surgery have been suggested as causes of SEL (21). In veterinary medicine, the case of SEL secondary to long-term steroid use has recently been reported (16).…”

Section: Introductionmentioning

confidence: 99%

Spinal Epidural Lipomatosis Secondary to Hypothyroidism in a Siberian Husky Dog

et al. 2022

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A 10-year-old neutered male Siberian Husky presented with paraparesis and severe lethargy. On physical examination, the patient was unable to weight-bear and walk and exhibited significant muscle mass loss in both hindlimbs and generalized truncal alopecia with a dull coat of hair. On neurological examination, cranial lumbar vertebral pain, hind limb cross-extensor reflex, delayed hindlimb postural reaction, upper motor neuron bladder dysfunction, and total absence of cutaneous trunci reflex were identified. Computed tomography revealed diffuse idiopathic skeletal hyperostosis and spondylosis deformans of the cervical and thoracolumbar vertebrae. In addition, a generalized decrease in bone mineral density of the vertebrae was identified. Magnetic resonance imaging showed hyperplasia of the epidural fat compressing the spinal cord in the thoracolumbar region and concurrent mild multiple intervertebral disc herniations. No specific findings were observed in cerebrospinal fluid analysis. Blood analysis of thyroid function revealed decreased total T4 and free T4 levels, and increased TSH levels. The patient was tentatively diagnosed with spinal epidural lipomatosis (SEL) secondary to hypothyroidism. The patient was treated with levothyroxine, firocoxib, and gabapentin. Clinical signs gradually improved, and the patient showed normal ambulation 40 days after treatment initiation. SEL is extremely rare in dogs. To the best of our knowledge, this is the first case report of SEL secondary to hypothyroidism that was treated conservatively. Secondary SEL can be sufficiently managed by treating the underlying cause, if possible.

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Spinal Epidural Lipomatosis: A Comprehensive Review

Cited by 27 publications

References 75 publications

Bilateral Lower Extremity Weakness: Spinal Epidural Lipomatosis or more?

Bilateral Lower Extremity Weakness: Spinal Epidural Lipomatosis or more?

Spinal epidural lipomatosis and focal posterior longitudinal ligament hypertrophy causing severe cauda equina crowding

Spinal Epidural Lipomatosis Secondary to Hypothyroidism in a Siberian Husky Dog

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