Lumbar Spinal Epidural Lipomatosis: Two Cases Report / 대한척추외과학회지

ABSTRACT

STUDY DESIGN: We report two cases of symptomatic spinal epidural lipomatosis (SEL) associated with long-term use of steroid medication OBJECTIVES: The purpose of this study was to assess the clinical characteristics, diagnosis and treatment of symptomatic spinal epidural lipomatosis. SUMMARY OF LITERATURE REVIEW Spinal epidural lipomatosis is a condition in which excess adipose tissue is deposited circumferentially about the spinal cord in the epidural space. It can present neurologic symptoms including back pain, radiculopathy or cauda equina. Magnetic resonance imaging is the most helpful dignostic means and should be used initially if suspected. Treatment is decompressive laminectomy and debulking of fat. MATERIALS AND METHODS: Two cases of lumbar epidural lipomatosis with neurologic symptoms were discussed and evaluated by physical examination, postmyelography CT and MRI. RESULTS: Two cases were treated with decompressive laminectomy and debulking of fat. Increased accumulation of the fatty tissue was seen predominently in posterior and posterolateral epidural space of the spinal canal, displacing and compressing the lumbar spinal cord anteriorly. Both gross and histologic evaluation revealed overgrowth of unencapsulated normal appearing fat consistent with spinal epidural lipomatosis. One case was demonstrated gradual improvement in symtoms after operation but the other was died due to medical problems. CONCLUSION: The authors reviewed the literature and reported the results of operative treatment of patients with lumbago, radicular pain and intermitent claudication caused by epidural lipomatosis of lumbar spine and degenerative spinal stenosis.