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

Neal, Matthew T.; Patra, Devi Prasad; Lyons, Mark

doi:10.3171/case21595

Cited by 2 publications

(1 citation statement)

References 42 publications

(72 reference statements)

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“…The role of surgery in spinal epidural lipomatosis is well established. Most authors describe spinal decompression via laminectomies, with some variations, such as the interesting method of alternating hemilaminotomies described recently by Mart ınez Santos et al 10 and Neal et al 11 However, the question remains: Why was the conventional laminoplasty not enough in our case?…”

Section: Surgical Treatment Of Spinal Epidural Lipomatosismentioning

confidence: 92%

Symptomatic thoracic epidural lipomatosis with syringomyelia: illustrative case

Przepiórka

Wójtowicz

Kunert

2023

Journal of Neurosurgery: Case Lessons

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BACKGROUND Spinal epidural lipomatosis is a rare but well-described disease. Here the authors present an extraordinary co-occurrence of spinal epidural lipomatosis with syringomyelia that did not improve after laminoplasty but required duroplasty as a definitive treatment. OBSERVATIONS This is the seventh case in the literature describing a co-occurrence of spinal epidural lipomatosis and syringomyelia. The pragmatic argument for a causative relationship between 2 phenomena is syrinxes reduction after surgery for spinal epidural lipomatosis. Additionally, duroplasty for spinal epidural lipomatosis in the setting of syringomyelia has not previously been reported. Duroplasty offers much better reconstruction of the subarachnoid space as compared with extradural decompression surgeries. It is one of the treatment options for spinal epidural lipomatosis. Last, most of the patients described in the literature with secondary syringomyelia were women with diabetes mellitus. LESSONS The co-occurrence of spinal epidural lipomatosis and syringomyelia is extremely rare. Neurological deficits in such cases respond well to surgical treatment. Accordingly, each case described in the literature resulted in syringomyelia reduction or resolution after surgery. Duroplasty may be necessary in selected cases of spinal epidural lipomatosis. Close follow-up and ongoing management of patients with epidural lipomatosis is therefore important.

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Section: Surgical Treatment Of Spinal Epidural Lipomatosismentioning

confidence: 92%

Symptomatic thoracic epidural lipomatosis with syringomyelia: illustrative case

Przepiórka

Wójtowicz

Kunert

2023

Journal of Neurosurgery: Case Lessons

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Could Spinal Epidural Lipomatosis Be the Hallmark of Metabolic Syndrome on the Spine? A Literature Review with Emphasis on Etiology

et al. 2023

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Spinal epidural lipomatosis is defined by an excessive amount of epidural fat in the spinal canal, usually in the lumbosacral tract: a well-known cause of lumbar pain and spinal stenosis with a possible wide range of neurological symptoms. Recent research data reveal that, nowadays, obesity has become the main cause of spinal epidural lipomatosis. Moreover, this condition was recently recognized as a previously unknown manifestation of metabolic syndrome. Radiological studies (CT and MRI) are the only tools that are able to diagnose the disease non-invasively. Indeed, radiologists play a key role in disease recognition, with subsequent possible implications on patients’ systemic health assessments. Despite its clinical importance, the condition is still underreported and neglected. The current literature review summarizes all the main etiologies of spinal epidural lipomatosis, particularly regarding its linkage with metabolic syndrome. An overview of disease characteristics from diagnosis to treatment strategies is also provided.

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

Cited by 2 publications

References 42 publications

Symptomatic thoracic epidural lipomatosis with syringomyelia: illustrative case

Symptomatic thoracic epidural lipomatosis with syringomyelia: illustrative case

Could Spinal Epidural Lipomatosis Be the Hallmark of Metabolic Syndrome on the Spine? A Literature Review with Emphasis on Etiology

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