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Lumbar epidural lipomatosis is associated with visceral fat and metabolic disorders

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Abstract

Purpose

Lumbar spinal epidural lipomatosis (LEL) is a condition characterized by excessive deposition of epidural fat in the spinal canal. Metabolic abnormalities may be associated with LEL, but few validated reports exist. Thus, we investigated the association between LEL and metabolic disorders in this study.

Methods

A total of 218 patients who had neurological symptoms due to neural compression in the lumbar spinal canal were examined by magnetic resonance imaging (MRI), abdominal computed tomography (CT) scans and blood tests. We evaluated the epidural fat, dural sac and spinal canal areas using MRI, and the visceral fat and subcutaneous fat areas using abdominal CT. We compared the patients’ demographics and the radiological parameters between the LEL and non-LEL patients.

Results

There were 58 LEL patients and 160 non-LEL patients. The LEL group included more men than women. In the MRI measurement, the dural sac area was similar between the LEL and non-LEL patients; however, the epidural fat/spinal canal ratio was much greater in the LEL group. In the LEL patients, factors associated with metabolic disorders, such as visceral fat area, uric acid (UA) and insulin levels, were significantly greater, compared to the non-LEL patients. In the logistic regression analysis, UA and visceral fat area were the independent explanatory factors in the pathogenesis of LEL.

Conclusions

LEL patients had significantly more visceral fat and increased levels of insulin, UA and ferritin, which are closely related with metabolic disorders. This study indicates that the increased epidural fat in the spinal canal seen in the LEL patients is associated with metabolic syndrome.

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Acknowledgements

We gratefully acknowledge Dr. Toshihiko Ohama MD to help our work.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Saiseikai Kawaguchi General Hospital, 5-11-5 Nishikawaguchi, Kawaguchi-shi, Saitama, 332-8558, Japan

    Shingo Morishita, Yoshiyasu Arai & Kenichiro Sakai

  2. Department of Orthopaedic Surgery, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan

    Shingo Morishita, Toshitaka Yoshii, Takashi Hirai & Atsushi Okawa

Authors
  1. Shingo Morishita
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  2. Yoshiyasu Arai
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  3. Toshitaka Yoshii
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Correspondence to Toshitaka Yoshii.

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Morishita, S., Arai, Y., Yoshii, T. et al. Lumbar epidural lipomatosis is associated with visceral fat and metabolic disorders. Eur Spine J 27, 1653–1661 (2018). https://doi.org/10.1007/s00586-018-5584-2

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  • DOI: https://doi.org/10.1007/s00586-018-5584-2

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