Spinal epidural lipomatosis – literature review and case report

Abstract

Spinal epidural lipomatosis is a rare disease leading to the compression of the dural sac. The clinical manifestation in patients is displayed by a variety of neurological symptoms – from mild radicular complaints to severe neurological deficit with bladder disorders. It occurs as a result of exogenous steroid use or endogenous production of corticosteroids. Various concomitant diseases, such as diabetes mellitus and obesity, contribute to the rapid development of severe stenosis. As a result, adipose tissue gradually begins to form and accumulate in the epidural space, leading to compression of the nerve roots and myelon. Treatment primarily involves reducing or stopping (if possible) concomitant corticosteroid therapy or establishing the cause of the endogenous pathology.
A different approach is applied to the individual patient in treatment: symptomatic therapy to control the pain, and in the case of worsening complaints (gait disturbance and bladder disorders) surgery is required to remove the compression.