Lumbar epidural lipomatosis is associated with visceral fat and metabolic disorders

Morishita, Shingo; Arai, Yoshiyasu; Yoshii, Toshitaka; Sakai, Kenichiro; Hirai, Takashi; Okawa, Atsushi

doi:10.1007/s00586-018-5584-2

Cited by 24 publications

(28 citation statements)

References 24 publications

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“…The statistical results show that the heterogeneity between the initial studies is significant, the source of heterogeneity may be that there is no uniform standard for the diagnosis of SEL in various studies. Four studies 17,18,20,23 defined SEL as an EF/SpiC index greater than 0.4 or 0.6, four reviews 19,21,24 diagnosed as SEL based on MRI showing enlarged fat tissue compressing the dura sac, two studies 14,22 obtained the diagnosis basis based on clinical symptoms and signs and MRI imaging but did not clearly explain. The results showed significant heterogeneity after the initial combination of effect sizes ( I 2 = 98%).…”

Section: Resultsmentioning

confidence: 99%

Obesity is a risk factor for epidural lipomatosis: a meta-analysis

Yuan

et al. 2021

J Orthop Surg (Hong Kong)

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Purpose: The purpose of this meta-analysis was to summarize the evidence of associations between obesity factors and spinal epidural lipomatosis (SEL) and to evaluate the strength and validity of these associations. Methods: Electronic databases such as Wiley Online Library, PubMed, Embase, Cochrane Library were searched and manual retrieval of references, the time limit was from the establishment of the database to May 2020. Methodological quality evaluations of the included studies were assessed using the bias risk assessment tool recommended by the Cochrane Guidelines. The RevMan 5.3 software was used for meta-analysis. Results: Finally, seven studies were included for meta-analysis, all of which were observational studies with mixed bias risk. These studies involved 807 patients, with an average age of 64 to 73.6 years, and 59.4 percent of the participants were male. The sample sizes for the included studies ranged from 28 to 288. The results of meta-analysis showed that high body mass index (BMI) was one of the factors affecting SEL ( P < 0.01, MD 1.37, 95% CI [0.81, 1.92]). All reviews had a high risk of bias, and the most common source of bias was that there was no strict unified case diagnosis standard between researches, and some studies (four items) did not clearly describe the confounders that they controlled. Conclusions: We suggest that physicians should consider high BMI as a factor leading to SEL, and to control body weight actively should be considered as the preferred treatment strategy before surgical intervention is conducted.

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Section: Resultsmentioning

confidence: 99%

Obesity is a risk factor for epidural lipomatosis: a meta-analysis

Yuan

et al. 2021

J Orthop Surg (Hong Kong)

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“…Obesity is considered the most common cause of SEL unrelated to steroid use. 1,26,48 It was found that 24.5% of SEL cases were associated with obesity-related factors. 26 Obesity is thought to cause chronic inflammation and subsequent hypertrophy of adipose tissue in the spinal canal.…”

Section: Obesitymentioning

confidence: 99%

Spinal Epidural Lipomatosis: A Comprehensive Review

et al. 2021

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“…Such analysis demonstrated the following: BMI, abdominal circumference, and visceral fat area were all significantly correlated with epidural fat accumulation, and the incidence of LSEL was significantly higher in the individuals with metabolic syndrome than in those without metabolic syndrome. Other research groups also have investigated such correlations, with Morishita et al reporting that LSEL was strongly correlated with visceral fat 49) and Abe et al reporting that epidural fat accumulation was strongly correlated with accumulation of fat in the liver 50) . Recently, the concept of ectopic fat has been proposed as a third type of fat, separate from subcutaneous fat and visceral fat, and excessive storage of ectopic fat in organs can diminish their functions 51) .…”

Section: Lumbar Spinal Epidural Lipomatosis and Metabolic Syndromementioning

confidence: 99%

Lumbar Spinal Canal Stenosis from the Perspective of Locomotive Syndrome and Metabolic Syndrome: A Narrative Review

Fujita

2021

Spine Surg Relat Res

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Patients with lumbar spinal canal stenosis (LSS) have impaired activities of daily living because of pain or motor paralysis, but no effective preventive treatment is currently available. The number of patients with LSS is predicted to continually increase as the average age of the global population increases. To provide a conceptual framework for improving healthy life expectancy, the Japanese Orthopaedic Association introduced the concept of locomotive syndrome, to which LSS is related. Ours and other studies have shown that LSS exacerbates locomotive syndrome and that surgical treatment is one method for improving it. Furthermore, we propose that the two-step test, a locomotive syndrome risk test, is effective for assessing the risk for falls and severity of LSS. Meanwhile, lumbar spinal epidural lipomatosis (LSEL), which is a manifestation of LSS, has been shown to be related to metabolic syndrome. Previous studies have suggested that the whole LSS can be also associated with metabolic syndrome. Although locomotive syndrome is very different from metabolic syndrome, which involves lipid metabolism, these two syndromes overlap, such as in LSS. Conducting research on LSS from the perspectives of both locomotive syndrome and metabolic syndrome may lead to novel methods for prevention and treatment of LSS and, conversely, may yield clues for resolving symptoms of the two syndromes. This review 2 provides an overview of LSS from the perspective of locomotive syndrome and metabolic syndrome, along with findings from our research group.

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Lumbar epidural lipomatosis is associated with visceral fat and metabolic disorders

Cited by 24 publications

References 24 publications

Obesity is a risk factor for epidural lipomatosis: a meta-analysis

Obesity is a risk factor for epidural lipomatosis: a meta-analysis

Spinal Epidural Lipomatosis: A Comprehensive Review

Lumbar Spinal Canal Stenosis from the Perspective of Locomotive Syndrome and Metabolic Syndrome: A Narrative Review

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