Clinical research progress of spinal epidural lipomatosis / 中国修复重建外科杂志

OBJECTIVE@#To review the clinical research progress of spinal epidural lipomatosis (SEL).@*METHODS@#The clinical studies on SEL at home and abroad in recent years were extensively reviewed, and the pathogenesis, clinical and imaging manifestations, and treatment status of SEL were summarized and analyzed.@*RESULTS@#SEL is a disease characterized by compression of the spinal cord and nerve roots due to abnormal accumulation of epidural adipose tissue in the spinal canal. Its prevalence and diagnosis rate are low and the pathogenesis is not fully understood. MRI is the most sensitive and specific diagnostic test for SEL. Surgical decompression and removal of excess adipose tissue are the only options for patients with acute SEL or those who have failed conservative management, and conservative management should be considered for other patients.@*CONCLUSION@#SEL is a rare disease and related research still needs to be improved. In the future, high-quality, multi-center and large-sample studies will be of great significance for evaluating the choice of treatment methods and effectiveness of SEL patients.

Spinal Epidural Lipomatosis in Korean

Spinal epidural lipomatosis (SEL) is a rare disorder, regarded in literature as a consequence of administration of exogenous steroids, associated with a variety of systemic diseases, endocrinopathies and the Cushing's syndrome. Occasionally, SEL may occur in patients not exposed to steroids or suffering from endocrinopathies, namely, idiopathic SEL. Thus far, case studies of SEL among Korean have been published rather sporadically. We reviewed the clinical features of SEL cases, among Koreans with journal review, including this report of three operated cases. According to this study, there were some differences between Korean and western cases. Koreans had higher incidences of idiopathic SEL, predominant involvement in the lumbar segments, very few thoracic involvement and lower MBI, as opposed to westerners.

Steroid-induced Spinal Epidural Lipomatosis after Suprasella Tumor Resection

Spinal epidural lipomatosis (SEL) is an abnormal localized accumulation of fat tissues in the epidural space. It is strongly related with steroid administration. The symptoms of SEL are various and range from back pain to paraplegia. In severe cases, decompressive laminectomy is the choice of treatment. A 32-year-old woman who had been under long-term steroid administration after suprasellar tumor resection was admitted for both leg radiating pain and weakness. She was diagnosed with SEL and had a decompressive laminectomy. During the operation, we found the nerve roots were compressed by epidural fat tissues and engorged vessels. After the operation, her radiating pain was relieved and motor weakness was improved.

Spinal Epidural Lipomatosis: A case report

Spinal epidural lipomatosis (SEL) is a rare condition of pathological overgrowth of fat tissue in the vertebral canal. SEL leads to back pain, radiculopathy or paraparesis. Glucocorticoids seem to play a major role in the development of SEL. SEL is best diagnosed by magnetic resonance imaging. The treatment of SEL is directed at reducing the body weight and decreasing the excess glucocorticoid. In severe cases, decompressive laminectomy with removal of the excess epidural fat might become necessary to alleviate the neurological symptoms caused by spinal cord compression.

Symptomatic Spinal Epidural Lipomatosis Induced by Repeated Epidural Steroid Injections

We present a very rare case of symptomatic spinal epidural lipomatosis(SEL) induced by repeated epidural steroid injections. A 59-year-old woman presented with severe neurogenic claudication and bilateral radiating leg pain aggravated for 1 year. She had undergone epidural triamcinolone injections 19 times for 3 years in a local clinic for chronic low back pain. At first, there had been no symptoms of lumbar stenosis such as leg pain or claudication. During the period of injections, radiating leg pain and claudication appeared newly and were gradually aggravated. Hormonal study and physical examination confirmed iatrogenic Cushing's syndrome. Magnetic resonance imaging(MRI) revealed extensive epidural fat deposition compressing cauda equnina from L3 to S1. Therefore, we concluded that multiple epidural steroid injections caused iatrogenic Cushing's syndrome and SEL. We performed debulking of epidural fat and bilateral neural decompression via left unilateral partial hemilaminectomy at L3-4-5-S1 in order to preserve stability considering preexisting multiple compression fractures. After operation, the patient's neurogenic claudication and radiating pain were completely disappeared.

Lumbar Spinal Stenosis Induced by Epidural Lipomatosis: A case report

The epidural lipomatosis is the unusual result of fat deposition in the extradural space of spinal canal, and most cases are associated with the chronic systemic steroid treatment. Symptoms related to spinal stenosis are postulated to result from spinal cord and nerve root compression. MR imaging is the first choice of the investigation method. Patients with acute progressive symptoms are best treated surgically, while others with stable symptoms can initially be treated medically with immediate tapering of their steroid dose. We reported one case of lumbar spinal stenosis induced by epidural lipomatosis receiving chronic steroid treatment. Surgical treatment could not be performed because of the poor general condition. Rehabilitation care and nonoperative therapy were effective in improving symptoms in lumbar epidural spinal stenosis induced by epidural lipomatosis.

Epidural Lipomatosis Discovered during Managing of Lower Back Pain: A case report / 대한마취과학회지

We experienced a case of lumbar epidural lipomatosis patient who had been treated with several epidural steroid injection for the management of lower back pain. This 67-years-old man, complained of lower back pain and radiating paresthetic pain to the dorsum of left foot. Epidural lipomatosis is a rare condition of focal or multiple deposition of excessive adipose tissue in epidural space. Since excessive deposited adipose tissue compresses the spinal cord or spinal root, patients complaint the atypical low back pain and low extremity radiculopathy which mimics the symptoms of spinal stenosis or herniated nucleus pulposus. In managing of lower back pain patient, especially who had been treated with steroid previously, we should consider that epidural lipomatois would be one of the cause.