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KMID : 1146020100030010057
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Journal of Critical Spine Cases
2010 Volume.3 No. 1 p.57 ~ p.60
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Alternative Unilateral Laminectomy for Bilateral Decompression for Thoracic Idiopathic Spinal Epidural Lipomatosis
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Koo Sang-Keun
Hwang Byeong-Wook
Lee Sang-Ho
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Abstract
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Spinal epidural lipomatosis (SEL) is accumulation of unencapsulated fat tissue within the epidural space of the spinal canal. It occurs in patients with exogenous steroid treatment, endogenous Cushing's syndrome, endocrinopathies, or morbid obesity. The most common cause of SEL is corticosteroid therapy. Idiopathic SEL in the absence of exposure to steroids or endocrinopathies has been reported rarely, primarily in obese individuals. We report one case of symptomatic idiopathic SEL. A 66-year-old man presented with back pain, both low extremity radiating pain and weakness. His weight was 77 kg, his height was 171 cm and body mass index was 26.33 kg/m on physical examination. There was no history of steroid intake. He underwent a 6 months trial of weight reduction and was able to lose 12 kg without improvement in neurological status. The patient had never taken steroids. Magnetic resonance imaging demonstrated lipomatosis of thoracic spine with significant compression between T2 and T10. We performed alternating unilateral laminectomy for bilateral decompression and fat removal between T2 and T10. The patient's symptoms improved after decompression surgery. The idiopathic SEL is a truly rare condition as reported in published research and idiopathic SEL should be considered as a differential diagnosis in any patients presenting with severe neurologic symptoms. Also, surgical decompression was highly effective in improving symptoms of severe idiopathic SEL. We have described one case of symptomatic idiopathic SEL being treated using surgical decompression. The patient experienced symptomatic relief after surgery.
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KEYWORD
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Unilateral laminectomy, Bilateral decompression, Epidural lipomatosis
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