Spinal epidural lipomatosis following bilateral spinal decompression surgery

BMJ Case Rep. 2019 Feb 15;12(2):e226985. doi: 10.1136/bcr-2018-226985.

Abstract

A 73-year-old man underwent bilateral spinal decompression of L4/5 for severe spinal canal stenosis, requiring minimal analgesia and providing immediate relief. Two days post-operatively, he presented with new onset bilateral leg pain and difficulty mobilising. MRI demonstrated spinal epidural lipomatosis (SEL), which was not present pre-operatively, at L5/S1. Further surgery was performed with decompression of L5/S1 through removal of epidural fat. At both 3 weeks and 5 months follow-up clinics, the patient was asymptomatic. To our knowledge, this is the first case of acute spinal epidural lipomatosis directly following spinal surgery. It is important to recognise SEL as a complication following spinal surgical intervention, due to the potential development of significant neurological consequences.

Keywords: orthopaedic and trauma surgery; radiology.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Decompression, Surgical* / adverse effects
  • Epidural Space / diagnostic imaging
  • Epidural Space / pathology*
  • Epidural Space / surgery
  • Humans
  • Lipomatosis / diagnostic imaging
  • Lipomatosis / pathology*
  • Lipomatosis / surgery
  • Magnetic Resonance Imaging
  • Male
  • Postoperative Complications
  • Spinal Cord Diseases / diagnostic imaging
  • Spinal Cord Diseases / pathology*
  • Spinal Cord Diseases / surgery
  • Spinal Stenosis / physiopathology
  • Spinal Stenosis / surgery*
  • Treatment Outcome