Spinal epidural lipomatosis: a known or unknown quantity?
Symptomatic spinal epidural lipomatosis (SEL) ofthe thoracic or lumbar spine is a rare disease. With a pathomechanism that is poorly understood, it is most commonly observedinpatientswithlong-term exogenous steroidtherapy, endogenous steroid overproduction or obesity; idiopathic SEL is even less common.
The signs and symptoms of SEL depend on the level and degree of spinal cord and/or nerve root compression and are identical with those from degenerative bony or ligamentous stenosis or disc herniation, i.e. myelopathy, radiculopathy or neurogenic claudication.
The best diagnostic tool is MRI, where a focal increase in epidural fat is seen as hyperintensity on T1- and T2-weighted sequences. Recognition of SEL is important, since effective therapeutic options exist such as weight and/or steroid reduction. Should conservative treatment fail, or in severe cases, surgical decompression is a possibility which offers good results.
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Spinale epidurale Lipomatose