Idiopathic Spinal Epidural Lipomatosis in the Lumbar Spine

被引:23
|
作者
Al-Omari, Ali A. [1 ]
Phukan, Rishabh D. [2 ]
Leonard, Dana A. [3 ]
Herzog, Tyler L. [4 ]
Wood, Kirkham B. [4 ]
Bono, Christoptopher M. [3 ]
机构
[1] Jordan Univ Sci & Technol, King Abdullah Univ Hosp, Dept Special Surg, Div Orthopaed Surg, Irbid Amman St,POB 3030, Irbid 22110, Jordan
[2] Univ Massachusetts, Sch Med, Worcester, MA USA
[3] Brigham & Womens Hosp, Dept Orthopaed Surg, 75 Francis St, Boston, MA 02115 USA
[4] Harvard Univ, Massachusetts Gen Hosp, Sch Med, Dept Orthopaed Surg, Boston, MA USA
关键词
STEROID INJECTIONS; WEIGHT-REDUCTION; COMPRESSION; DECOMPRESSION; SECONDARY; FAT; OBESITY;
D O I
10.3928/01477447-20160315-04
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Overgrowth of epidural fat, known as spinal epidural lipomatosis (SEL), can cause symptomatic compression of the spinal cord, conus medullaris, or cauda equina. Suggested predisposing factors such as obesity, steroid use, and diabetes mellitus have been based on a few reported cases, many of which were not surgically confirmed. There is a paucity of epidemiological data in surgically confirmed cases for this disorder. The purpose of this independently reviewed, retrospective, matched cohort analysis was to compare the demographics and incidence of comorbidities of patients who underwent lumbar decompression for SEL vs degenerative stenosis without SEL. Two surgeons' databases were reviewed to identify patients older than 18 years who underwent decompression surgery for magnetic resonance imaging-verified, symptomatic lumbar SEL. A matched control group comprised an equal number of patients with degenerative stenosis (n=14). Demographic data, body mass index, symptom type/duration, comorbidities, complications, treatment history, and associated pathology were collected from medical records. Previously suggested risk factors, such as obesity, endocrinopathy, and epidural steroid injections, were not significantly different between the SEL and control groups. Furthermore, there were no differences in operative times, complications, or blood loss. The only noted difference between the 2 groups was the preoperative duration of symptoms, on average double in patients with SEL. This series represents the largest of its kind reported to date. Because symptom duration was the only difference noted, it is postulated to be the result of lack of awareness of SEL. Future prospective study in a larger group of patients is warranted.
引用
收藏
页码:163 / 168
页数:6
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