Is epidural lipomatosis a contraindication to epidural steroid?
The MRI-based early diagnosis and staging[5] of epidural lipomatosis (that may present with or without symptoms) directs pain physicians to consider epidural lipomatosis as an absolute contraindication for interventional pain procedures with steroids because epidural interventions may fail to provide analgesia due to …
Is epidural lipomatosis serious?
Purpose: The lumbar epidural lipomatosis (LEL) is a rare disease that can cause sciatic pain syndrome or neurological deficits comparable to symptoms caused by a classical spinal canal stenosis. In severe cases surgical decompression was conducted.
Can epidural lipomatosis be cured?
Spinal epidural lipomatosis is most commonly associat- ed with long-term use of exogenous steroids, but can be seen with a number of other conditions. Conservative treatment, with either weight loss or weaning from steroids, can successfully reduce epidural adipose tissue leading to an improvement in symptoms.
What is treatment for epidural lipomatosis?
Treatment Options for Epidural Lipomatosis Conservative treatment options can include weight loss and weaning off of steroids. If these treatment options fail to relieve pain, a minimally invasive laminectomy or decompression spine surgery may be the best course of treatment.
Does epidural lipomatosis hurt?
Symptoms vary, but back pain and weakness are the most common ones. Other possible signs may be a loss of sensation or reflexes that are too slow or too fast. Epidural lipomatosis affects men more than women.
What is thoracic epidural lipomatosis?
Abstract. Spinal epidural lipomatosis (SEL) is an overgrowth of the normally encapsulated adipose tissue in the epidural space around the spinal cord in the thoracic and lumbar spine causing compression of the neural components. Idiopathic SEL in non-obese patients is exceptional.
How common is epidural lipomatosis?
Epidural lipomatosis is a rare disorder in which an abnormal amount of fat is deposited on or outside the lining of the spine. It may press on the spinal cord and nerves.
How do you lose epidural fat?
Conservative therapy, either weight loss or withdrawal of steroids, may reduce epidural adipose tissue leading to an improvement of symptoms. Decompressive laminectomy with resection of the epidural fat is also very successful in improving neurological symptoms.
Is epidural fat normal?
Fat tissue is normally present between the vascular, neural and ligamentous structures of the epidural space. In the large majority of individuals, the amount of fat tissue within the epidural space does not appreciably change with age, or as the individual becomes obese or underweight.
What is Thoracic lipomatosis?
Spinal epidural lipomatosis (SEL) is an overgrowth of the normally encapsulated adipose tissue in the epidural space around the spinal cord in the thoracic and lumbar spine causing compression of the neural components.
What causes spinal lipomatosis?
This is usually associated with excess of steroids in the body either because of endogenous source as in Cushings disease or exogenous intake as in some diseases like systemic lupus erythematosus, in some endocrinopathies or in morbid obesity. But in some cases no cause has been found.
Does weight loss help epidural lipomatosis?
There have been other case reports showing that weight loss improves spinal stenosis related to epidural lipomatosis. Thus, this case report adds to the growing evidence that weight loss should be the first line of treatment in patients with epidural lipomatosis where excess weight is felt to be an underlying issue.