European Spine Journal

, Volume 27, Issue 7, pp 1653–1661 | Cite as

Lumbar epidural lipomatosis is associated with visceral fat and metabolic disorders

  • Shingo Morishita
  • Yoshiyasu Arai
  • Toshitaka Yoshii
  • Kenichiro Sakai
  • Takashi Hirai
  • Atsushi Okawa
Original Article



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.


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.


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.


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.

Graphical abstract

These slides can be retrieved under Electronic Supplementary material.


Epidural fat Lumbar epidural lipomatosis Abdominal computed tomography Visceral fat Metabolic syndrome 



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

Compliance with ethical standards

Conflict of interest

None of the authors has any potential conflict of interest.

Supplementary material

586_2018_5584_MOESM1_ESM.pptx (1 mb)
Supplementary material 1 (PPTX 1028 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Shingo Morishita
    • 1
    • 2
  • Yoshiyasu Arai
    • 1
  • Toshitaka Yoshii
    • 2
  • Kenichiro Sakai
    • 1
  • Takashi Hirai
    • 2
  • Atsushi Okawa
    • 2
  1. 1.Department of Orthopaedic SurgerySaiseikai Kawaguchi General HospitalSaitamaJapan
  2. 2.Department of Orthopaedic Surgery, Graduate SchoolTokyo Medical and Dental UniversityTokyoJapan

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