Symptomatic spinal epidural lipomatosis after local epidural corticosteroid injections: case report.
OBJECTIVE
Spinal epidural lipomatosis, which causes symptomatic compression of neural elements, is a well known but uncommon complication of Cushing's syndrome. Spinal epidural lipomatosis has been reported frequently in association with chronic systemic corticosteroid therapy, but thus far only one case has been attributed to local epidural corticosteroid injections.


METHODS
We report another case of symptomatic spinal epidural lipomatosis after epidural corticosteroid injections. This is the first such case documented by magnetic resonance imaging and confirmed with surgical exploration.


METHODS
The patient's symptoms of neurogenic claudication resolved after lumbar laminectomy in the region of previous corticosteroid injections and the removal of epidural fat, which was compressing the thecal sac.


CONCLUSIONS
This case should alert clinicians that epidural lipomatosis, which causes symptomatic thecal sac compression, is a possible complication, not only of systemic glucocorticoid therapy, but also of local epidural corticosteroid injections.
Division of Neurosurgery, Weill Medical College of Cornell University, New York Presbyterian Hospital, New York, USA.
D I
DI
Sandberg
M H
MH
Lavyne
D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects*; D019299:Decompression, Surgical; D006801:Humans; D007268:Injections, Epidural; D007796:Laminectomy; D008068:Lipomatosis / Q000139:chemically induced* / Q000175:diagnosis / Q000601:surgery; D008159:Lumbar Vertebrae / Q000187:drug effects / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D000077555:Methylprednisolone Acetate; D013117:Spinal Cord Compression / Q000139:chemically induced* / Q000175:diagnosis / Q000601:surgery; D013122:Spinal Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000601:surgery; D013130:Spinal Stenosis / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D014221:Triamcinolone / Q000008:administration & dosage / Q000009:adverse effects*
D000893:Anti-Inflammatory Agents; D014221:Triamcinolone; D000077555:Methylprednisolone Acetate; D008775:Methylprednisolone