Advertisement

European Spine Journal

, Volume 17, Supplement 2, pp 225–227 | Cite as

Idiopathic spinal epidural lipomatosis: urgent decompression in an atypical case

  • A. López-GonzálezEmail author
  • M. Resurrección Giner
Case Report

Abstract

Symptomatic spinal epidural lipomatosis (SEL) is very rare and frequently associated to chronic exogenous steroid use, obesity and Cushing syndrome. The idiopathic cases where no identifiable association with SEL are found constitute only 17% of all cases. The usual clinical manifestations of this entity consist of dorsal or lumbar pain with paresthesias and weakness in lower limbs, but acute symptoms of myelopathy are exceptional. We report a case of acute paraparesis and urinary retention caused by thoracic SEL in a 55-year-old male who did not have any recognized predisposing factor for this condition. Urgent surgical decompression was performed in order to relieve the symptoms. Slow but progressive improvement was assessed after surgery. We consider this case to be exceptional due to the needing to perform an urgent decompressive laminectomy to treat a rapidly progressive myelopathy caused by idiopathic SEL.

Keywords

Epidural lipomatosis Paraparesis Spinal cord compression Surgical decompression Myelopathy 

Notes

Conflict of interest statement

None of the authors has any potential conflict of interest.

References

  1. 1.
    Arroyo IL, Barron KS, Brewer EJ (1982) Spinal cord compression by epidural lipomatosis simulating an acute herniated nucleus pulposus. J Neurosurg 57:559–562CrossRefGoogle Scholar
  2. 2.
    Berman M, Feldman S, Alter M, Zilber N, Kahana E (1981) Acute transverse myelitis: incidence and etiologic considerations. Neurology 31:966–971PubMedGoogle Scholar
  3. 3.
    Borre DG, Borre GE, Aude F, Palmieri GN (2003) Lumbosacral epidural lipomatosis: MRI grading. Eur Radiol 13:1709–1721PubMedCrossRefGoogle Scholar
  4. 4.
    Fogel GR, Cunningham PY, Esses SI (2005) Spinal epidural lipomatosis: case reports, literature review and meta-analysis. Spine J 5:202–211PubMedCrossRefGoogle Scholar
  5. 5.
    George WE, Wilmot M, Greenhouse A, Hammeke M (1983) Medical management of steroid-induced epidural lipomatosis. New Engl J Med 308:316–319PubMedCrossRefGoogle Scholar
  6. 6.
    Ishikawa Y, Shimada Y, M Miyakoshi N, Suzuki T, Hongo M, Kasukawa Y, Okada K, Itoi E (2006) Decompression of idiopathic lumbar epidural lipomatosis: diagnostic magnetic resonance imaging evaluation and review of the literature. J Neurosurg Spine 4:24–30PubMedCrossRefGoogle Scholar
  7. 7.
    Jungreis CA, Cohen WA (1987) Spinal cord compression induced by steroid therapy: CT findings. J Comput Assist Tomogr 11:245–247PubMedCrossRefGoogle Scholar
  8. 8.
    Kaplan JG, Barasch E, Hirschfeld A, Ross L, Einberg K, Gordon M (1989) Spinal epidural lipomatosis: a serious complication on iatrogenic Cushing’s syndrome. Neurology 39:1031–1034PubMedGoogle Scholar
  9. 9.
    Porras-Estrada LF, Díaz-Pérez de Madrid J, Cabezudo-Artero JM, Lorenzana-Honrado L, Rodríguez-Sánchez JA, Ugarriza-Echebarrieta F (2002) Spinal extradural lipomatosis. Revision of 108 cases. Case induced by exogenous contribution of ACTH. Neurocirugia 13:463–471PubMedGoogle Scholar
  10. 10.
    Quint DJ, Boulos RS, Sanders WP, Mehta BA, Patel SC, Tiel RL (1998) Epidural lipomatosis. Radiology 169:485–490Google Scholar
  11. 11.
    Robertson SC, Traynelis VC, Foller KA, Menezes AH (1997) Idiopathic spinal epidural lipomatosis. Neurosurgery 41:68–75PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  1. 1.Department of NeurosurgeryHospital Universitario La FeValenciaSpain
  2. 2.ValenciaSpain

Personalised recommendations