Lumbosacral epidural lipomatosis causing rapid onset cauda equina syndrome.
Spinal epidural lipomatosis (SEL) is a rare cause of cauda equina syndrome (CES), which must be diagnosed with MRI in conjunction with a high level of clinical suspicion. Most reported cases are associated with obesity, steroid use or are secondary to endocrinopathies, frequently present subacutely or chronically, and have been managed with both surgical decompression and non-operative measures. We describe an obese 55-year-old man with rapid onset CES secondary to idiopathic lumbosacral SEL which was managed successfully with surgical decompression. Although often thought to be a trivial radiological finding, it is important not to be dismissive of patients presenting with compressive neuropathy and MRI evidence of space-occupying SEL.
Department of Neurosurgery, Flinders Medical Centre, Flinders Drive, Bedford Park, Adelaide, SA 5042, Australia. Electronic address: adam.wells@health.sa.gov.au.
Adam J
AJ
Wells
Department of Neurosurgery, Flinders Medical Centre, Flinders Drive, Bedford Park, Adelaide, SA 5042, Australia.
Matthew J
MJ
McDonald
Department of Neurosurgery, Flinders Medical Centre, Flinders Drive, Bedford Park, Adelaide, SA 5042, Australia.
Simon J I
SJ
Sandler
Department of Neurosurgery, Flinders Medical Centre, Flinders Drive, Bedford Park, Adelaide, SA 5042, Australia.
Nikitas J
NJ
Vrodos
D019299:Decompression, Surgical; D004824:Epidural Space / Q000473:pathology*; D006801:Humans; D008068:Lipomatosis / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011128:Polyradiculopathy / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery
Cauda equina syndrome; Epidural lipomatosis; Surgery