Spinal epidural lipomatosis – A brief review

Al-Khawaja, Darweesh; Seex, Kevin; Eslick, Guy D.

doi:10.1016/j.jocn.2008.03.001

Cited by 100 publications

(120 citation statements)

References 50 publications

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“…The symptoms usually depend on the level of canal compromise. SEL at the thoracic levels produces myelopathy, and SEL at the lumbar levels results in radiculopathy caused by direct mechanical compression and indirect vascular dysfunction [7]. According to the literature, SEL is associated with exogenous steroid intake, obesity, and Cushing's syndrome [1].…”

Section: Discussionmentioning

confidence: 99%

Rapid progression of spinal epidural lipomatosis

et al. 2011

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Spinal epidural lipomatosis (SEL) is a rare but well-recognized condition. In general, the onset of its symptoms is insidious and the disease progresses slowly. We report two cases of rapid progression of SEL with no history of steroid intake in non-obese individuals after epidural steroid injection. These SEL patients developed neurologic symptoms after less than 5 months; these symptoms were confirmed to be due to SEL by serial MR images. After the debulking of the epidural fat, their symptoms improved.

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Section: Discussionmentioning

confidence: 99%

Rapid progression of spinal epidural lipomatosis

et al. 2011

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“…Idiopathic SEL in non-obese patients is exceptional 3,12,13,26) . According to previous reports, idiopathic SEL can result in thoracic myelopathy and lumbar radiculopathy 2,4,8,9,13,19) . To our knowledge, a thoracic radiculopathy due to idiopathic SEL has not been reported yet.…”

Section: Introductionmentioning

confidence: 89%

Idiopathic Thoracic Epidural Lipomatosis with Chest Pain

Lee

Park

Chang

et al. 2011

J Korean Neurosurg Soc

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was 22.8 kg/m 2 which was within the normal range. Neurologic examination revealed paresthesia on the left side, at the level of the T5 and T6 dermatomes, without myelopathy, motor weakness or claudication (Fig. 1). Hyperesthesia and allodynia were not evident. Laboratory evaluation, including full blood count, electrolytes, creatinine, liver function test, vitamin B12 and folate, urine analysis and culture, thyroid function tests, adrenocorticotropic hormone, and cortisol, were all unremarkable.Plain radiographs of the thoracic spine showed no abnormalities. Myelography computed tomography (CT) demonstrated a hypodense soft tissue mass within the posterior spinal canal and mainly in left vertebral foramen on T4/5 and 5/6 level ( Fig. 2).Magnetic resonance image (MRI) of the thoracic region presented a posterior compressing mass lesion of increased signal intensity on T1-weighted image (WI) and T2 WI in the epidural space, suggesting an epidural lipomatosis in the thoracic area. INTRODUCTIONSpinal epidural lipomatosis (SEL) is an overgrowth of the normally encapsulated adipose tissue in the epidural space around the spinal cord in the thoracic and lumbar spine causing compression of the neural components 5,12,13,25,26,32,34) . In cases without definite predisposing factors, the term 'idiopathic SEL' has been used. Idiopathic SEL in non-obese patients is exceptional 3,12,13,26) . According to previous reports, idiopathic SEL can result in thoracic myelopathy and lumbar radiculopathy 2,4,8,9,13,19) . To our knowledge, a thoracic radiculopathy due to idiopathic SEL has not been reported yet.We report a case of chest pain caused by idiopathic thoracic SEL in a female patient who did not have any other recognized predisposing factors for this condition. CASE REPORTA 16-year-old girl presented with a 2-month history of pain on her left chest. She reported that the pain spontaneously started around 2 months prior to admission and got worse over the two weeks. She could not do her usual daily living activities due to the intractable pain. She had no medical history for diabetes or steroid intake. On physical examination, her body weight was 55 kg and height was 155 cm, her body mass index Spinal epidural lipomatosis (SEL) is an overgrowth of the normally encapsulated adipose tissue in the epidural space around the spinal cord in the thoracic and lumbar spine causing compression of the neural components. Idiopathic SEL in non-obese patients is exceptional. Idiopathic SEL can result in thoracic myelopathy and lumbar radiculopathy. A thoracic radiculopathy due to idiopathic SEL has not been reported yet. We report a case of idiopathic SEL with intractable chest pain and paresthesia. We suggest that idiopathic SEL should be considered as a cause of chest pain.

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“…Conservative treatment options include weight loss for overweight patients, combined with physical rehabilitation and pain management [8]. Weight loss may be beneficial even for non-obese patients, as for our case, and should be recommended systematically.…”

Section: Introductionmentioning

confidence: 86%

“…SEL-onset features are insidious and non specific, but delayed diagnosis may lead to severe functional disabilities. Back pain is the most common first symptom, followed by weakness of the lower extremities, and ataxia [7,8].…”

Section: Case Reportmentioning

confidence: 99%