Spinal Epidural Lipomatosis: a Case Report and Review of the Literature

Study Overview
=================
Brief Summary
-----------------
Introduction Lumbar spinal epidural lipomatosis (SEL) is a rare condition defined by an excessive deposition of adipose tissue in the lumbar spinal canal. The objective of this case report is to document a clinical case of SEL presenting within a multidisciplinary spine clinic and to compare our clinical findings and management with the current literature. Case presentation A 51-year-old female presented at a spine clinic with low back pain, bilateral leg pain and difficulty walking. MR imaging of the lumbar spine showed L4-L5 and L5-S1 degenerative disk disease with evidence of severe central canal stenosis due to extensive epidural lipomatosis. The patient was initially advised to lose weight, undergo a course of physiotherapy, and consult with the pain clinic. Because of lack of improvement, the patient was scheduled for L4-S1 posterior spinal decompression and L4-L5 posterior spinal instrumented fusion. Discussion The discussion will include the diagnosis of SEL, imaging appearance, its risk factors, etiology and management. Conclusion This case report describes a case of lumbar spinal stenosis due to SEL with neurological symptoms. Some risk factors have also been identified in the literature. MRI is considered as the reference standard for its diagnosis. The therapeutic approach of patients with SEL is not standardized. Thus, reporting and investigating the diagnostic process and treatment of this patient will positively contribute to better management for other future patients.

Official Title
-----------------
Spinal Epidural Lipomatosis: a Case Report and Review of the Literature

Conditions
-----------------
Spinal Stenosis

Intervention / Treatment
-----------------
* Procedure: posterior spinal decompression and posterior spinal instrumented fusion


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Adults patient with a clinical diagnosis of Spinal Epidural Lipomatosis (MRI and clinical diagnosis) Exclusion Criteria: Absence of clinical diagnosis of Spinal Epidural Lipomatosis

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 100 Years

Sexes Eligible for Study
-----------------
All

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Intervention/Treatment |
| --- |
|Procedure: posterior spinal decompression and posterior spinal instrumented fusion|posterior spinal decompression and posterior spinal instrumented fusion performed on a patient with Spinal Epidural Lipomatosis|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Low back pain | Visual Pain Scale (0-10) | 3 months before surgery | 
| Low back pain | Visual Pain Scale (0-10) | 6 weeks after surgery | 
| Distance Walking | Distance walking (meter) | 3 months before surgery | 
| Distance Walking | Distance walking (meter) | 6 weeks after surgery | 
| Low back pain | Visual Pain Scale (0-10) | 3 months after surgery | 
| Low back pain | Visual Pain Scale (0-10) | 1 year after surgery | 
| Distance walking | Distance walking (meter) | 3 months after surgery | 
| Distance walking | Distance walking (meter) | 1 year after surgery |