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CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(01): 180-183
DOI: 10.4103/ajns.AJNS_255_19
Case Report

Idiopathic epidural lipomatosis associated with degenerative discopathy: Grand round presentation of unusual lumbar canal stenosis resolved by weight loss

Mohammad Alsofyani
1   Department of Spinal Surgery Unit, Bordeaux University Hospital, Bordeaux University, C.H.U Tripode Pellegrin, Place Amélie Raba Léon, 33076 Bordeaux, France
2   Department of Orthopedics, College of Medicine and University Hospital, University of Hail, Hail City, Kingdom of Saudi Arabia
,
Vincent Haignere
1   Department of Spinal Surgery Unit, Bordeaux University Hospital, Bordeaux University, C.H.U Tripode Pellegrin, Place Amélie Raba Léon, 33076 Bordeaux, France
,
Sultan Alsalmi
3   Department of Neurosurgery, Amiens University Medical Center, Amiens University, Amiens, France
4   Department of Neurosurgery, Imam Abdulrahman Bin Faisal University, Dammam City, Kingdom of Saudi Arabia
,
Olivier Gille
1   Department of Spinal Surgery Unit, Bordeaux University Hospital, Bordeaux University, C.H.U Tripode Pellegrin, Place Amélie Raba Léon, 33076 Bordeaux, France
,
Jean-Marc Vital
1   Department of Spinal Surgery Unit, Bordeaux University Hospital, Bordeaux University, C.H.U Tripode Pellegrin, Place Amélie Raba Léon, 33076 Bordeaux, France
,
Vincent Pointillart
1   Department of Spinal Surgery Unit, Bordeaux University Hospital, Bordeaux University, C.H.U Tripode Pellegrin, Place Amélie Raba Léon, 33076 Bordeaux, France
,
Louis Boissi
1   Department of Spinal Surgery Unit, Bordeaux University Hospital, Bordeaux University, C.H.U Tripode Pellegrin, Place Amélie Raba Léon, 33076 Bordeaux, France
,
Ibrahim Obeid
1   Department of Spinal Surgery Unit, Bordeaux University Hospital, Bordeaux University, C.H.U Tripode Pellegrin, Place Amélie Raba Léon, 33076 Bordeaux, France
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Here, we report a case of idiopathic epidural lipomatosis presented with a clinical picture of lumbar canal stenosis with neurogenic claudication which resolved completely only by weight loss. A 53-year-old obese male with a body mass index of 36 without significant past medical history presented to the outpatient clinic with neurogenic claudication and bilateral sciatic radiculopathy. Initially, magnetic resonance imaging (MRI) showed epidural lipomatosis at the level of L5 vertebral body and L5–S1 intervertebral disc. A conservative treatment was decided with dietary regime program. After 6 months of follow-up, his bilateral sciatic radiculopathy disappeared, and updated MRI showed complete disappearance of epidural lipomatosis. Based on the Grand Round case and relevant literature, we present a case of an unusual epidural lipomatosis with mixed clinical picture of degenerative lumbar disease. This case report set out the importance of Borré classification for differentiating the mixed clinical complaint of degenerative discopathy and epidural lipomatosis.

Key-words:

Degenerative discopathy - epidural lipomatosis - weight loses

Financial support and sponsorship

Nil.




Publication History

Received: 14 August 2019

Accepted: 13 November 2019

Article published online:
16 August 2022

© 2020. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Kirkaldy-Willis WH, Wedge JH, Yong-Hing K, Reilly J. Pathology and pathogenesis of lumbar spondylosis and stenosis. Spine (Phila Pa 1976) 1978;3:319-28.
  • 2 Al-Khawaja D, Seex K, Eslick GD. Spinal epidural lipomatosis – A brief review. J Clin Neurosci 2008;15:1323-6.
  • 3 George WE Jr., Wilmot M, Greenhouse A, Hammeke M. Medical management of steroid-induced epidural lipomatosis. N Engl J Med 1983;308:316-9.
  • 4 McCullen GM, Spurling GR, Webster JS. Epidural lipomatosis complicating lumbar steroid injections. J Spinal Disord 1999;12:526-9.
  • 5 Fessler RG, Johnson DL, Brown FD, Erickson RK, Reid SA, Kranzler L. Epidural lipomatosis in steroid-treated patients. Spine (Phila Pa 1976) 1992;17:183-8.
  • 6 Noël P, Pepersack T, Vanbinst A, Allé JL. Spinal epidural lipomatosis in Cushing's syndrome secondary to an adrenal tumor. Neurology 1992;42:1250-1.
  • 7 Yildirim B, Puvanesarajah V, An HS, Novicoff WM, Jain A, Shen FH, et al. Lumbosacral epidural lipomatosis: A retrospective matched case-control database study. World Neurosurg 2016;96:209-14.
  • 8 Borstlap AC, van Rooij WJ, Sluzewski M, Leyten AC, Beute G. Reversibility of lumbar epidural lipomatosis in obese patients after weight-reduction diet. Neuroradiology 1995;37:670-3.
  • 9 Pouchot J, Si-Hassen C, Damade R, Bayeux MC, Mathieu A, Vinceneux P. Cauda equina compression by epidural lipomatosis in obesity. Effectiveness of weight reduction. J Rheumatol 1995;22:1771-5.
  • 10 Qasho R, Ramundo OE, Maraglino C, Lunardi P, Ricci G. Epidural lipomatosis with lumbar radiculopathy in one obese patient. Case report and review of the literature. Neurosurg Rev 1997;20:206-9.
  • 11 Kumar K, Nath RK, Nair CP, Tchang SP. Symptomatic epidural lipomatosis secondary to obesity. Case report. J Neurosurg 1996;85:348-50.
  • 12 Badami JP, Hinck VC. Symptomatic deposition of epidural fat in a morbidly obese woman. AJNR Am J Neuroradiol 1982;3:664-5.
  • 13 Haddad SF, Hitchon PW, Godersky JC. Idiopathic and glucocorticoid-induced spinal epidural lipomatosis. J Neurosurg 1991;74:38-42.
  • 14 Quint DJ, Boulos RS, Sanders WP, Mehta BA, Patel SC, Tiel RL. Epidural lipomatosis. Radiology 1988;169:485-90.
  • 15 Hierholzer J, Vogl T, Hosten N, Lanksch W, Felix R. Imaging in epidural lipomatosis. Crit Rev Neurosurg 1998;8:279-81.
  • 16 Borré DG, Borré GE, Aude F, Palmieri GN. Lumbosacral epidural lipomatosis: MRI grading. Eur Radiol 2003;13:1709-21.
  • 17 Kuhn MJ, Youssef HT, Swan TL, Swenson LC. Lumbar epidural lipomatosis: The “Y” sign of thecal sac compression. Comput Med Imaging Graph 1994;18:367-72.
  • 18 Patel AJ, Sellin J, Ehni BL, Tatsui CE. Spontaneous resolution of spinal epidural lipomatosis. J Clin Neurosci 2013;20:1595-7.
  • 19 van Rooij WJ, Borstlap AC, Canta LR, Tijssen CC. Lumbar epidural lipomatosis causing neurogenic claudication in two obese patients. Clin Neurol Neurosurg 1994;96:181-4.
  • 20 Beges C, Rousselin B, Chevrot A, Godefroy D, Vallee C, Berenbaum F, et al. Epidural lipomatosis. Interest of magnetic resonance imaging in a weight-reduction treated case. Spine (Phila Pa 1976) 1994;19:251-4.
  • 21 Maillot F, Mulleman D, Mammou S, Goupille P, Valat JP. Is epidural lipomatosis associated with abnormality of body fat distribution? A case report. Eur Spine J 2006;15:105-8.