Idiopathic symptomatic epidural lipomatosis of the lumbar spine.
BACKGROUND
Symptomatic spinal epidural lipomatosis (SEL) of the lumbar spine is a rare disease, often associated with steroid overload. Idiopathic lipomatosis is even much less frequent. Signs and symptoms depend upon the level and degree of nerve root compression. Diagnosis is best based on MRI. Weight reduction can be curative, however after failure of medical treatment or in severe cases surgical decompression should be performed.


METHODS
Four patients with severe symptoms of lumbar spinal epidural lipomatosis were treated by surgical decompression. Patient history and neurological examination are described, diagnostic imaging is demonstrated, surgical treatment and outcome are documented. Different surgical techniques including laminectomy, interlaminar fenestration and lateral recess decompression were applied and are discussed.


RESULTS
All four patients improved after surgery. No surgical complications were observed. Even though limited to four cases this is the second largest series of operated idiopathic spinal epidural lipomatosis.


CONCLUSIONS
Surgical decompression was effective in improving symptoms in severe lumbar idiopathic spinal epidural lipomatosis.
Payer
M
M
Department of Neurosurgery, University Hospital of Geneva, Switzerland.
Van Schaeybroeck
P
P
Reverdin
A
A
May
D
D
D000368:Aged; D004824:Epidural Space / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008068:Lipomatosis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D008161:Lumbosacral Region / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011843:Radiculopathy / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D013122:Spinal Diseases / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D014057:Tomography, X-Ray Computed