Steroid-Induced Spinal Epidural Lipomatosis

Incidence of spinal epidural lipomatosis in patients with spinal stenosis

“…Prior studies and research have demonstrated a high occurrence rate of in SEL patients with previous epidural steroid injections (ESI), higher body mass index (BMI), prior spine surgeries, systemic steroid use, diabetes mellitus (DM), and other endocrinopathies. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Seventeen patients had epidural steroid injections (ESI) prior to diagnosis of SEL, giving a rate of 33%. Thirty-Five percent (7/20) of the Grade 3 patients had ESI.…”

“…The condition can be idiopathic, but it is often associated with obesity, endocrinopathies (such as the high cortisol state seen in Cushing Disease/Syndrome), systemic steroid use, and epidural steroid injections. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] The lumbar and thoracic vertebrae are the most common areas implicated in the disease. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] The first reported case of SEL was seen by Lee et al in 1975.…”

“…9 After which, many other case reports have been reported in the literature. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] We performed a retrospective analysis in a community setting in the Pacific Northwest, U.S.A to identify the true incidence and rate of SEL in patients with spinal stenosis. It is also noted that many of these patients have concurrent degenerative spinal canal comprise creating a lower threshold for the SEL to be associated with a symptomatic presentation.…”

Volumetric evaluation of lumbar epidural fat distribution in epidural lipomatosis and back pain in patients who are obese: introducing a novel technique (Fat Finder algorithm)

“…This condition has been associated with exogenous steroid administration, Cushing’s syndrome, and obesity 9 13–15. Its pathophysiology is poorly understood with a few isolated case reports linking obesity and steroid excess 8 16–18. A 2005 review of 104 isolated cases of EL revealed four general categorical associations: exogenous and endogenous steroid excess, obesity and idiopathic causes 9.…”

Neurogenic claudication by epidural lipomatosis: a case report and review of literature

“…SLE [4,5], dermatomyositis [6], rheumatoid arthritis [7], chronic obstructive pulmonary disease [3,8]). Epidural lipomatosis is uncommon in patients with an endogenous elevation of steroids, as in Cushing's syndrome [9].…”