Mostafa Khaleghipour - Anesthesiologist, pain fellowship

Epidural lipomatosis is a rare condition that requires aggressive treatments especially if the spinal cord or the nerve roots are compressed. It may affect any age group but is more common in middle aged patients. The most common symptoms of idiopathic epidural lipomatosis are low back pain, radicular pain, sensory loss, burning dysesthesia, motor weakness and bladder dysfunction. Exogenous steroid therapy is the most common cause for this condition.The condition arises when there is excessive deposition of adipose tissue in the epidural space which is in most cases circumferential. Likely risk factors such as morbid obesity, hypothyroidism, Cushing’s syndrome, and immunosuppressive therapy should be considered in patients receiving steroid therapy on a chronic basis. Magnetic resonance imaging is the gold standard for evaluating such symptoms due to its higher reliability to differentiate the soft tissues. Aggressive therapy with extensive laminectomies and fusion are required in patients exhibiting signs and symptoms of spinal cord or nerve root compression. Milder symptoms may be managed conservatively.

Epidural lipomatosis, Steroid therapy, symptoms, Magnetic resonance imaging