Spinal Epidural Lipomatosis – Three Case Reports

Czech version

Authors: T. Andrašinová ¹; B. Adamová ^1,2; J. Stulík ³; J. Beck ¹; K. Starý ⁴; S. Voháňka ^1,2; Z. Bálintová ⁵
Authors‘ workplace: Neurologická klinika LF MU a FN Brno ¹; CEITEC – Středoevropský technologický institut, MU, Brno ²; Radiologická klinika LF MU a FN Brno ³; Interní gastroenterologická klinika LF MU a FN Brno ⁴; Klinika dětské neurologie LF MU a FN Brno ⁵
Published in: Cesk Slov Neurol N 2016; 79/112(1): 93-99
Category: Case Report
doi: https://doi.org/10.14735/amcsnn201693

Overview

Spinal epidural lipomatosis (SEL) is a condition associated with pathological fat accumulation in the epidural area of the spinal canal. The disorder is likely caused by the use of corticosteroids, obesity, endocrinal disorders (especially endogenous overproduction of cortisol), although, in some cases, no cause is immediately evident. SEL rarely becomes symptomatic unless it leads to compression of the spinal cord or nerve roots. Clinical manifestation depends on the level at which the spinal canal is affected. Severity of compression of nerve structures and the corresponding intensity of clinical syndrome are the most important factors in the choice of SEL therapy. Recent classifications for evaluation of epidural fat layer on radiographic images by Borré (for lumbar spine) and Quint (for thoracic spine) can help in guiding the diagnostic and treatment approaches. Therapeutic options include conservative therapy (reduction of body weight, reduction of any corticoid dosage, treatment of the endocrinal disorder, analgesics, rehabilitation) and surgical decompression. However, SEL itself is rare and is frequently found together with other (e.g. degenerative) spinal changes. We report three cases from our own patient base through which we demonstrate possible causes, course and therapy of this disorder. Lipomatosis manifested as cauda equina syndrome in the first patient, as radicular syndrome in the second, and SEL led to compression of the thoracic spinal cord in the third.

Key words:
spinal epidural lipomatosis – epidural fat – spinal canal – stenosis

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

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