Spinal epidural lipomatosis.

Department of Neurosurgery, China Medical College Hospital, Taichung, Taiwan, ROC.
Zhonghua yi xue za zhi = Chinese medical journal; Free China ed 03/2002; 65(2):86-9.
Source: PubMed


Epidural lipomatosis is an uncommon disorder defined as a pathologic overgrowth of normal epidural fat. It is most often associated with administration of exogenous steroids of variable duration and dose. However, it can occur in the absence of exposure to steroids. We report two cases of spinal epidural lipomatosis following more than 20 years of steroid use due to asthma. Pathologic compression fracture due to osteoporosis and acute cord compression syndrome were found in these 2 cases. After emergent decompressive laminectomy and fusion surgery, neurological function recovered. From a review of literature, most patients received decompressive laminectomy surgery. But in our additional cases, we performed decompressive laminectomy and fusion surgery which might prevent further spinal deformity and improve the spinal stability, then patients' symptoms subsided completely. Therefore, decompression surgery and fusion surgery may be necessary in patients with symptomatic spinal epidural lipomatosis with compression fracture.

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    ABSTRACT: Spinal epidural lipomatosis is a condition in which there is excessive synthesis of normal epidural fat. Most cases are associated with long-term steroid administration 1,2 or obesity. 3 Occasionally the disorder occurs because of excessive endogenous steroid production in Cushing's syndrome 4,5 or suppressed lipolysis in hypothyroidism. 6 Idiopathic extradural lipomatosis is rare. 7 The disorder usually presents with chronic localized back pain often of several months' duration. We report an unusual case in which a non-obese person, without any of the above risk factors, presented acutely with severe back pain following a lumbar puncture for suspected subarachnoid haemorrhage. The symptoms were subsequently found to be due to spinal epidural lipomatosis. A brief review of the relevant literature is also presented.
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    ABSTRACT: Spinal epidural lipomatosis (SEL) is a rare condition characterized by overgrowth of normal adipose tissue in the extradural space within the spinal canal that can lead to significant spinal cord compression. It is most commonly reported in patients receiving chronic glucocorticoid therapy. Other causes can include obesity and hypercortisolism. Occasionally, idiopathic SEL will occur in patients with no known risk factors, but cases are more generally reported in obesity and males. We present the case of a 35 year-old non-obese woman found to have rapidly progressive SEL that was not associated with any of the common causes of the disorder.
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