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Spine
Diagnosis
Neoplasms, Cysts, and Other Masses
Nonneoplastic Cysts and Tumor Mimics
Nonneoplastic Masses and Tumor Mimics
Epidural Lipomatosis
Epidural Lipomatosis
Kevin R. Moore, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Definitions

                • Excessive accumulation of intraspinal fat causing cord compression and neurologic deficits

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Nonvascular Interventions

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        Selected References

                                        1. Kim K et al: Spinal epidural lipomatosis: a review of pathogenesis, characteristics, clinical presentation, and management. Global Spine J. 9(6):658-65, 2019
                                        2. Ishihara S et al: Spinal epidural lipomatosis is a previously unrecognized manifestation of metabolic syndrome. Spine J. 19(3):493-500, 2018
                                        3. Morishita S et al: Lumbar epidural lipomatosis is associated with visceral fat and metabolic disorders. Eur Spine J. 27(7):1653-61, 2018
                                        4. Papastefan ST et al: Management of idiopathic spinal epidural lipomatosis: a case report and review of the literature. Childs Nerv Syst. 34(4):757-63, 2018
                                        5. Singh J et al: Neonatal epidural lipomatosis: a rare case. J Pediatr Neurosci. 13(2):267-69, 2018
                                        6. Yasuda T et al: Clinical and imaging characteristics in patients undergoing surgery for lumbar epidural lipomatosis. BMC Musculoskelet Disord. 19(1):66, 2018
                                        7. Al-Yafeai R et al: Spinal cord compression secondary to idiopathic thoracic epidural lipomatosis in an adolescent: a case report and review of literature. Int J Surg Case Rep. 37:225-9, 2017
                                        8. Yildirim B et al: Lumbosacral epidural lipomatosis: a retrospective matched case-control database study. World Neurosurg. 96:209-14, 2016
                                        9. Andreisek G et al: A systematic review of semiquantitative and qualitative radiologic criteria for the diagnosis of lumbar spinal stenosis. AJR Am J Roentgenol. 201(5):W735-46, 2013
                                        10. Brennan RC et al: Spinal epidural lipomatosis in children with hematologic malignancies. Ann Hematol. 90(9):1067-74, 2011
                                        11. Al-Khawaja D et al: Spinal epidural lipomatosis--a brief review. J Clin Neurosci. 15(12):1323-6, 2008
                                        12. Fassett DR et al: Spinal epidural lipomatosis: a review of its causes and recommendations for treatment. Neurosurg Focus. 16(4):E11, 2004
                                        13. Geers C et al: Polygonal deformation of the dural sac in lumbar epidural lipomatosis: anatomic explanation by the presence of meningovertebral ligaments. AJNR Am J Neuroradiol. 24(7):1276-82, 2003
                                        14. Payer M et al: Idiopathic symptomatic epidural lipomatosis of the lumbar spine. Acta Neurochir (Wien). 145(4):315-20; discussion 321, 2003
                                        15. Dumont-Fischer D et al: Spinal epidural lipomatosis revealing endogenous Cushing's syndrome. Joint Bone Spine. 69(2):222-5, 2002
                                        16. Lisai P et al: Cauda equina syndrome secondary to idiopathic spinal epidural lipomatosis. Spine (Phila Pa 1976). 26(3):307-9, 2001
                                        17. Citow JS et al: Thoracic epidural lipomatosis with associated syrinx: case report. Surg Neurol. 53(6):589-91, 2000
                                        18. McCullen GM et al: Epidural lipomatosis complicating lumbar steroid injections. J Spinal Disord. 12(6):526-9, 1999
                                        19. Fiirgaard B et al: Spinal epidural lipomatosis. Case report and review of the literature. Scand J Med Sci Sports. 7(6):354-7, 1997
                                        20. Robertson SC et al: Idiopathic spinal epidural lipomatosis. Neurosurgery. 41(1):68-74; discussion 74-5, 1997
                                        21. Benamou PH et al: Epidural lipomatosis not induced by corticosteroid therapy. Three cases including one in a patient with primary Cushing's disease (review of the literature). Rev Rhum Engl Ed. 63(3):207-12, 1996
                                        22. Hierholzer J et al: Epidural lipomatosis: case report and literature review. Neuroradiology. 38(4):343-8, 1996
                                        23. Kumar K et al: Symptomatic epidural lipomatosis secondary to obesity. Case report. J Neurosurg. 85(2):348-50, 1996
                                        24. Provenzale JM et al: Spinal angiolipomas: MR features. AJNR Am J Neuroradiol. 17(4):713-9, 1996
                                        25. Zentner J et al: Spinal epidural lipomatosis as a complication of prolonged corticosteroid therapy. J Neurosurg Sci. 39(1):81-5, 1995
                                        26. Beges C et al: Epidural lipomatosis. Interest of magnetic resonance imaging in a weight-reduction treated case. Spine. 19(2):251-4, 1994
                                        27. Kuhn MJ et al: Lumbar epidural lipomatosis: the "Y" sign of thecal sac compression. Comput Med Imaging Graph. 18(5):367-72, 1994
                                        28. Preul MC et al: Spinal angiolipomas. Report of three cases. J Neurosurg. 78(2):280-6, 1993
                                        29. Roy-Camille R et al: Symptomatic spinal epidural lipomatosis induced by a long-term steroid treatment. Review of the literature and report of two additional cases. Spine. 16(12):1365-71, 1991
                                        30. Healy ME et al: Demonstration by magnetic resonance of symptomatic spinal epidural lipomatosis. Neurosurgery. 21(3):414-5, 1987
                                        31. Randall BC et al: Epidural lipomatosis with lumbar radiculopathy: CT appearance. J Comput Assist Tomogr. 10(6):1039-41, 1986
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Pathology

                                                • Clinical Issues

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Definitions

                                                      • Excessive accumulation of intraspinal fat causing cord compression and neurologic deficits

                                                    IMAGING

                                                    • General Features

                                                      • Radiographic Findings

                                                        • CT Findings

                                                          • MR Findings

                                                            • Nonvascular Interventions

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Microscopic Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              Selected References

                                                                              1. Kim K et al: Spinal epidural lipomatosis: a review of pathogenesis, characteristics, clinical presentation, and management. Global Spine J. 9(6):658-65, 2019
                                                                              2. Ishihara S et al: Spinal epidural lipomatosis is a previously unrecognized manifestation of metabolic syndrome. Spine J. 19(3):493-500, 2018
                                                                              3. Morishita S et al: Lumbar epidural lipomatosis is associated with visceral fat and metabolic disorders. Eur Spine J. 27(7):1653-61, 2018
                                                                              4. Papastefan ST et al: Management of idiopathic spinal epidural lipomatosis: a case report and review of the literature. Childs Nerv Syst. 34(4):757-63, 2018
                                                                              5. Singh J et al: Neonatal epidural lipomatosis: a rare case. J Pediatr Neurosci. 13(2):267-69, 2018
                                                                              6. Yasuda T et al: Clinical and imaging characteristics in patients undergoing surgery for lumbar epidural lipomatosis. BMC Musculoskelet Disord. 19(1):66, 2018
                                                                              7. Al-Yafeai R et al: Spinal cord compression secondary to idiopathic thoracic epidural lipomatosis in an adolescent: a case report and review of literature. Int J Surg Case Rep. 37:225-9, 2017
                                                                              8. Yildirim B et al: Lumbosacral epidural lipomatosis: a retrospective matched case-control database study. World Neurosurg. 96:209-14, 2016
                                                                              9. Andreisek G et al: A systematic review of semiquantitative and qualitative radiologic criteria for the diagnosis of lumbar spinal stenosis. AJR Am J Roentgenol. 201(5):W735-46, 2013
                                                                              10. Brennan RC et al: Spinal epidural lipomatosis in children with hematologic malignancies. Ann Hematol. 90(9):1067-74, 2011
                                                                              11. Al-Khawaja D et al: Spinal epidural lipomatosis--a brief review. J Clin Neurosci. 15(12):1323-6, 2008
                                                                              12. Fassett DR et al: Spinal epidural lipomatosis: a review of its causes and recommendations for treatment. Neurosurg Focus. 16(4):E11, 2004
                                                                              13. Geers C et al: Polygonal deformation of the dural sac in lumbar epidural lipomatosis: anatomic explanation by the presence of meningovertebral ligaments. AJNR Am J Neuroradiol. 24(7):1276-82, 2003
                                                                              14. Payer M et al: Idiopathic symptomatic epidural lipomatosis of the lumbar spine. Acta Neurochir (Wien). 145(4):315-20; discussion 321, 2003
                                                                              15. Dumont-Fischer D et al: Spinal epidural lipomatosis revealing endogenous Cushing's syndrome. Joint Bone Spine. 69(2):222-5, 2002
                                                                              16. Lisai P et al: Cauda equina syndrome secondary to idiopathic spinal epidural lipomatosis. Spine (Phila Pa 1976). 26(3):307-9, 2001
                                                                              17. Citow JS et al: Thoracic epidural lipomatosis with associated syrinx: case report. Surg Neurol. 53(6):589-91, 2000
                                                                              18. McCullen GM et al: Epidural lipomatosis complicating lumbar steroid injections. J Spinal Disord. 12(6):526-9, 1999
                                                                              19. Fiirgaard B et al: Spinal epidural lipomatosis. Case report and review of the literature. Scand J Med Sci Sports. 7(6):354-7, 1997
                                                                              20. Robertson SC et al: Idiopathic spinal epidural lipomatosis. Neurosurgery. 41(1):68-74; discussion 74-5, 1997
                                                                              21. Benamou PH et al: Epidural lipomatosis not induced by corticosteroid therapy. Three cases including one in a patient with primary Cushing's disease (review of the literature). Rev Rhum Engl Ed. 63(3):207-12, 1996
                                                                              22. Hierholzer J et al: Epidural lipomatosis: case report and literature review. Neuroradiology. 38(4):343-8, 1996
                                                                              23. Kumar K et al: Symptomatic epidural lipomatosis secondary to obesity. Case report. J Neurosurg. 85(2):348-50, 1996
                                                                              24. Provenzale JM et al: Spinal angiolipomas: MR features. AJNR Am J Neuroradiol. 17(4):713-9, 1996
                                                                              25. Zentner J et al: Spinal epidural lipomatosis as a complication of prolonged corticosteroid therapy. J Neurosurg Sci. 39(1):81-5, 1995
                                                                              26. Beges C et al: Epidural lipomatosis. Interest of magnetic resonance imaging in a weight-reduction treated case. Spine. 19(2):251-4, 1994
                                                                              27. Kuhn MJ et al: Lumbar epidural lipomatosis: the "Y" sign of thecal sac compression. Comput Med Imaging Graph. 18(5):367-72, 1994
                                                                              28. Preul MC et al: Spinal angiolipomas. Report of three cases. J Neurosurg. 78(2):280-6, 1993
                                                                              29. Roy-Camille R et al: Symptomatic spinal epidural lipomatosis induced by a long-term steroid treatment. Review of the literature and report of two additional cases. Spine. 16(12):1365-71, 1991
                                                                              30. Healy ME et al: Demonstration by magnetic resonance of symptomatic spinal epidural lipomatosis. Neurosurgery. 21(3):414-5, 1987
                                                                              31. Randall BC et al: Epidural lipomatosis with lumbar radiculopathy: CT appearance. J Comput Assist Tomogr. 10(6):1039-41, 1986