Cauda equina syndrome secondary to idiopathic spinal epidural lipomatosis.
METHODS
Three cases of idiopathic epidural lipomatosis are reported.


OBJECTIVE
Description of the relationship between spinal pathologic overgrowth of fat tissue and neurologic symptoms.


BACKGROUND
Idiopathic epidural lipomatosis is a very rare condition; it is usually secondary to chronic steroid therapy or endocrinopathic diseases.


METHODS
Three men with a mean age of 58.5 years, who experienced intermittent claudication, bilateral radicular pain in both legs, and urinary dysfunction with hypoesthesia in the perineal region, were evaluated by plain radiography and magnetic resonance imaging, the results of which demonstrated a pathologic overgrowth of fat tissue in the spinal canal with a marked impingement of the dural sac. Obesity, endocrinopathic diseases, and chronic steroid therapy were excluded for all patients. Surgical treatment was performed by wide multilevel laminectomies, fat debulking, and instrumented posterolateral fusion.


RESULTS
After surgery there was a gradual improvement in symptoms and signs so that 2 years later the patients returned to daily activities and were neurologically normal.


CONCLUSIONS
Spinal epidural lipomatosis can be a cause of back pain but rarely radicular impingement. Magnetic resonance imaging is the procedure of choice. The treatment must be performed early by wide surgical decompression.
Department of Orthopaedic Surgery, University of Sassari, Italy.
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Lisai
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Doria
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Crissantu
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Meloni
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Conti
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Achene
D000368:Aged; D002420:Cauda Equina / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D019299:Decompression, Surgical / Q000009:adverse effects / Q000379:methods; D004388:Dura Mater / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008068:Lipomatosis / Q000150:complications* / Q000473:pathology* / Q000601:surgery; D008159:Lumbar Vertebrae / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011128:Polyradiculopathy / Q000209:etiology* / Q000473:pathology* / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000473:pathology / Q000628:therapy; D013115:Spinal Canal / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome