Symptomatic spinal epidural lipomatosis without exogenous steroid intake

Gero, B.; Chynn, K.-Y.

doi:10.1007/bf00698854

Cited by 22 publications

(14 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Some authors have documented the reversibility of LEL in obese patients after weight reduction [8,37,39]. In our literature review, 58% of obese patients (18 of 31 cases) with symptomatic LEL improved after conservative therapy [8,26,29,37,38,39,40,41,44,46], while 42% (13 of 31 cases) received surgical treatment [3,20,28,29,30,35,42,43,44,45]. We believe that these cases submitted to surgical decompression by means of laminectomies and fat debulking could be certainly reduced if LEL is timely diagnosed.…”

Section: Lel and Obesitymentioning

confidence: 91%

“…The relationship between LEL and obesity is well known and has been widely reported [3,8,20,26,28,29,30,32,35,37,38,39,40,41,42,43,44,45,46]. Some authors have documented the reversibility of LEL in obese patients after weight reduction [8,37,39].…”

Section: Lel and Obesitymentioning

confidence: 95%

“…The extreme compression of the thecal sac leads to neurologic dysfunction that may be insidious or precipitous, intermittent or continuous, including low back pain [3,4,6,7,8,9,12,24,26], radicular pain [7,24,26,27], neurogenic claudication [3,6,20,28,29], and, in some cases, cauda equina syndrome [20,30,31,32]. Hence, this MRI grade III may be considered as severe (symptomatic) LEL.…”

Section: Grade IIImentioning

confidence: 98%

“…Spinal epidural lipomatosis has been defined in different ways, all of them coincidental in their essence: "abnormal quantity of epidural fat" [1], "excess of epidural fat" [2], "increased amounts of normal epidural fat" [3], "excessive fat deposition within the spinal canal" [4,5,6], "pathological overgrowth of epidural fat" [7,8,9], and "simple hypertrophy of epidural fat" [10]. However, all previous reports leave unanswered the question of an objective quantitative measurement of the lumbar epidural fat (EF).…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Lumbosacral epidural lipomatosis: MRI grading

Borré¹,

Borré²,

Aude³

et al. 2002

Eur Radiol

124

148

View full text Add to dashboard Cite

Lumbosacral epidural lipomatosis (LEL) is characterized by excessive deposition of epidural fat (EF). The purpose of our retrospective study was to quantify normal and pathologic amounts of EF in order to develop a reproducible MRI grading of LEL. In this study of 2528 patients (1095 men and 1433 women; age range 18-84 years, mean age 47.3 years) we performed a retrospective analysis of MRI exams. We obtained four linear measurements at the axial plane parallel and tangent to the superior end plate of S1 vertebral body: antero-posterior diameter of dural sac (A-Pd DuS), A-Pd of EF, located ventrally and dorsally to the DuS, and A-Pd of the spinal canal (Spi C). We calculated (a) DuS/EF index and (b) EF/Spi C index. We developed the following MRI grading of LEL: normal, grade 0: DuS/EF index >or=1.5, EF/Spi C index or=75% (severe EF overgrowth). The MRI exams were evaluated independently by three readers. Intra- and interobserver reliabilities were obtained by calculating Kappa statistics. The MRI grading showed the following distribution: grade 0, 2003 patients (79.2%); LEL grade I, 308 patients (12.2%); LEL grade II, 165 patients (6.5%); and LEL grade III, 52 patients (2.1%). The kappa coefficients for intra- and interobserver agreement in a four-grade classification system were substantial to excellent: intraobserver, kappa range 0.79 [95% confidence interval (CI), 0.65-0.93] to 0.82 (95% CI, 0.70-0.95); interobserver, kappa range 0.76 (95% CI, 0.62-0.91) to 0.85 (95% CI, 0.73-0.97). In LEL grade I, there were no symptomatic cases due to fat hypertrophy. LEL grade II was symptomatic in only 24 cases (14.5%). In LEL grade III, all cases were symptomatic. A subgroup of 22 patients (42.3%) showed other substantial spinal pathologies (e.g., disk herniation). By means of simple reproducible measurements and indexes MRI grading enables a distinction between mild, moderate, and severe EF hypertrophy. Kappa statistics indicate that LEL can be reliably classified into a four-grade system by experienced observers.

show abstract

Section: Lel and Obesitymentioning

confidence: 91%

Section: Lel and Obesitymentioning

confidence: 95%

Section: Grade IIImentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Lumbosacral epidural lipomatosis: MRI grading

Borré¹,

Borré²,

Aude³

et al. 2002

Eur Radiol

124

148

View full text Add to dashboard Cite

show abstract

“…La lipomatose vertébrale épidurale (LVE) est une accumulation pathologique de graisses encapsulées dans l'espace épi-dural et le canal rachidien [1][2][3][4]. Face à une claudication neurogène ou radiculite lombaire, l'absence des étiologies courantes ne doit pas faire oublier la possibilité d'une LVE malgré sa rareté [5][6][7].…”

Section: Introductionunclassified