Rapid progression of spinal epidural lipomatosis after percutaneous endoscopic spine surgery mimicking disc herniation

Youn, Myung Soo; Woo, Young Ha; Shin, Jong Ki

doi:10.1016/j.ijscr.2020.06.083

Cited by 10 publications

(12 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…3,[30][31][32] Less invasive tissuepreserving decompression using endoscopic techniques has also been described. 10,33 Observations Given the patient's spinal cord compression spanning seven vertebral levels, an open surgical approach was recommended. Although the authors' preferred methods for spinal decompression involve endoscopic and tubular retractors, the time and additional patient risk associated with the extensive minimally invasive spine (MIS) decompression did not outweigh the benefits.…”

Section: Discussionmentioning

confidence: 99%

“…35 Reported outcomes after surgical treatment of SEL have ranged from moderate 9,32,34,36 to excellent. 3,10,18,[35][36][37][38][39][40][41] The reason for this variability is likely multifactorial. In this case, we presume that several factors contributed to the more modest neurological improvement.…”

Section: Discussionmentioning

confidence: 99%

“…However, other manifestations have included radiculopathy, myelopathy, neurogenic claudication, dysesthetic pain, weakness in the limbs, and even cauda equina syndrome. 12 Reported etiologies of SEL have included exogenous steroid use, 13 endogenous steroid hormonal disease, 11,14 obesity, 15,16 prior surgery, 10,17 and idiopathic disease. 18 In addition, comorbidities such as hyperlipidemia, 19 acquired immunodeficiency syndrome, 20 Scheuermann kyphosis (SK), 21 and Paget's disease of bone 22 have been associated with SEL.…”

mentioning

confidence: 99%

“…Presenting symptoms can vary, and those symptoms may develop rapidly or insidiously. 10 , 11 Back pain is the most common symptom associated with SEL. However, other manifestations have included radiculopathy, myelopathy, neurogenic claudication, dysesthetic pain, weakness in the limbs, and even cauda equina syndrome.…”

mentioning

confidence: 99%

“…Reported etiologies of SEL have included exogenous steroid use, 13 endogenous steroid hormonal disease, 11 , 14 obesity, 15 , 16 prior surgery, 10 , 17 and idiopathic disease. 18 In addition, c omorbidities such as hyperlipidemia, 19 acquired immunodeficiency syndrome, 20 Scheuermann kyphosis (SK), 21 and Paget’s disease of bone 22 have been associated with SEL.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Surgical management of thoracic myelopathy from long-segment epidural lipomatosis with skip hemilaminotomies: illustrative case

Neal

Patra

Lyons

2021

Journal of Neurosurgery: Case Lessons

View full text Add to dashboard Cite

BACKGROUND Thoracic spinal epidural lipomatosis (SEL) involves the pathological overgrowth of histologically normal, unencapsulated adipose tissue that can compress the spinal cord and cause myelopathy. SEL has been associated with multiple medical conditions, including Scheuermann kyphosis (SK). Optimal treatment strategies for SEL, especially in the setting of a sagittal spinal deformity, remain unclear. OBSERVATIONS In this report, the authors discussed surgical management of a patient with thoracic SEL and SK using skip hemilaminotomies for resection of the epidural adipose tissue. To the authors’ knowledge, only one other report described a similar surgical technique in a patient who did not have a spinal deformity. LESSONS When conservative efforts fail, thoracic SEL may require surgical treatment. Surgical planning must account for co-medical conditions such as SK. The described approach involving skip laminotomies, which minimizes spine destabilization, is a viable option to treat SEL spanning multiple spinal segments. Prognosis after surgical treatment varies and is impacted by multiple factors, including severity of preoperative neurological deficits.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Surgical management of thoracic myelopathy from long-segment epidural lipomatosis with skip hemilaminotomies: illustrative case

Neal

Patra

Lyons

2021

Journal of Neurosurgery: Case Lessons

View full text Add to dashboard Cite

show abstract

Outcome of posterior decompression for spinal epidural lipomatosis

Schmutzer-Sondergeld,

Zimmermann,

Trabold

et al. 2023

Acta Neurochir

View full text Add to dashboard Cite

Background In contrast to osteoligamentous lumbar stenosis (LSS), outcome of surgical treatment for spinal epidural lipomatosis (SEL) is still not well defined. We present risk factors for SEL and clinical long-term outcome data after surgical treatment for patients with pure SEL and a mixed-type pathology with combined SEL and LSS (SEL+LSS) compared to patients with pure LSS. Methods From our prospective institutional database, we identified all consecutive patients who were surgically treated for newly diagnosed SEL (n = 31) and SEL+LSS (n = 26) between 2018 and 2022. In addition, a matched control group of patients with pure LSS (n = 30) was compared. Microsurgical treatment aimed for posterior decompression of the spinal canal. Study endpoints were outcome data including clinical symptoms at presentation, MR-morphological analysis, evaluation of pain-free walking distance, pain perception by VAS-N/-R scales, and patient’s satisfaction by determination of the Odom score. Results Patients with osteoligamentous SEL were significantly more likely to suffer from obesity (body mass index (BMI) of 30.2 ± 5.5 kg/m2, p = 0.03), lumbar pain (p = 0.006), and to have received long-term steroid therapy (p = 0.01) compared to patients with SEL+LSS and LSS. In all three groups, posterior decompression of the spinal canal resulted in significant improvement of these symptoms. Patients with SEL had a significant increase in pain-free walking distance during the postoperative course, at discharge, and last follow-up (FU) (p < 0.0001), similar to patients with SEL+LSS and pure LSS. In addition, patients with pure SEL and SEL+LSS had a significant reduction in pain perception, represented by smaller values of VAS-N and -R postoperatively and at FU, similar to patients with pure LSS. In uni- and multivariate analysis, domination of lumbar pain and steroid long-term therapy were significant characteristic risk factors for SEL. Conclusions Surgical treatment of pure SEL and SEL+LSS allows significant improvement in pain-free walking distance and pain perception immediately postoperatively and in long-term FU, similar to patients with pure LSS.

show abstract

A challenging diagnosis of spinal epidural lipomatosis: A case report and review of the literature

Salman,

Ahmed,

Sharabati

et al. 2024

International Journal of Surgery Case Reports

View full text Add to dashboard Cite

Rapid progression of spinal epidural lipomatosis after percutaneous endoscopic spine surgery mimicking disc herniation

Cited by 10 publications

References 18 publications

Surgical management of thoracic myelopathy from long-segment epidural lipomatosis with skip hemilaminotomies: illustrative case

Surgical management of thoracic myelopathy from long-segment epidural lipomatosis with skip hemilaminotomies: illustrative case

Outcome of posterior decompression for spinal epidural lipomatosis

A challenging diagnosis of spinal epidural lipomatosis: A case report and review of the literature

Contact Info

Product

Resources

About