scholarly journals A New Subform? Fast-Progressing, Severe Neurological Deterioration Caused by Spinal Epidural Lipomatosis

2022 ◽  
Vol 11 (2) ◽  
pp. 366
Author(s):  
Thiemo Florin Dinger ◽  
Maija Susanna Eerikäinen ◽  
Anna Michel ◽  
Oliver Gembruch ◽  
Marvin Darkwah Oppong ◽  
...  

Spinal epidural lipomatosis (SEL) is a rare condition caused by hypertrophic growth of epidural fat. The prevalence of SEL in the Western world is approximately 1 in 40 patients and is likely to increase due to current medical and socio-economic developments. Rarely, SEL can lead to rapid severe neurological deterioration. The pathophysiology, optimal treatment, and outcome of these patients remain unclear. This study aims to widen current knowledge about this “SEL subform” and to improve its clinical management. A systematic literature review according to the PRISMA guidelines using PubMed, Scopus, Web of Science, and Cochrane Library was used to identify publications before 7 November 2021 reporting on acute/rapidly progressing, severe SEL. The final analysis comprised 12 patients with acute, severe SEL. The majority of the patients were male (9/12) and multimorbid (10/12). SEL mainly affected the thoracic part of the spinal cord (11/12), extending a median number of 7 spinal levels (range: 4–19). Surgery was the only chosen therapy (11/12), except for one critically ill patient. Regarding the outcome, half of the patients regained independence (6/11; = modified McCormick Scale ≤ II). Acute, severe SEL is a rare condition, mainly affecting multimorbid patients. The prognosis is poor in nearly 50% of the patients, even with maximum therapy. Further research is needed to stratify patients for conservative or surgical treatment.

2020 ◽  
Author(s):  
Bi Zhang ◽  
Haifeng Yuan ◽  
Lihong Hu ◽  
Muhammad Saad

Abstract Background: Many studies have investigated the relationship between spinal epidural lipomatosis and obesity, no meta-analysis of studies have provided definitive evidence. To summarize the evidence of associations between obesity factors and spinal epidural lipomatosis (SEL) and to evaluate the strength and validity of these associations. Methods: Electronic databases such as Wiley Online Library, PubMed, Embase, Cochrane Library were searched and manual retrieval of references, the time limit was from the establishment of the database to May 2020. The included literature was case-control studies that reported body mass index (BMI) and SEL correlation, and excluded any primary and secondary tumors or other compression diseases in the spinal canal. Methodological quality evaluations of the included studies were assessed using the bias risk assessment tool recommended by the Cochrane Guidelines. The RevMan 5.3 software was used for meta-analysis. Results: Finally, ten studies were included for systematic review, all of which were observational studies with mixed bias risk. These studies involved 1,541 patients, with an average age of 54.9 to 73.6 years, and 60.2 percent of the participants were male. The sample sizes for the included studies ranged from 28 to 398. The results of meta-analysis showed that high BMI was one of the factors affecting SEL. All reviews had a high risk of bias, and the most common source of bias was that there was no strict unified case diagnosis standard between researches, and some studies (four items) did not clearly describe the confounders that they controlled. Conclusions: We suggest that physicians should consider obesity as a factor leading to SEL, and to control body mass index actively should be considered as the preferred treatment strategy before surgical intervention is conducted.


2019 ◽  
Vol 63 (3) ◽  
Author(s):  
Pasquale Donnarumma ◽  
Lorenzo Nigro ◽  
Angela Ambrosone ◽  
Roberto Tarantino ◽  
Antonio Santoro ◽  
...  

PM&R ◽  
2015 ◽  
Vol 7 ◽  
pp. S113-S113
Author(s):  
Karen F. Cruz ◽  
Cheryl Benjamin ◽  
Raymond Lee ◽  
Mary H. Lawler

2009 ◽  
Vol 58 (3) ◽  
pp. 411-414
Author(s):  
Masaru Hiyoshi ◽  
Shinichiro Kubo ◽  
Hiroshi Kuroki ◽  
Hideaki Hamanaka ◽  
Shoji Hanado ◽  
...  

2015 ◽  
Vol 22 (8) ◽  
pp. 1244-1249 ◽  
Author(s):  
Moshe Praver ◽  
Benjamin C. Kennedy ◽  
Jason A. Ellis ◽  
Randy D’Amico ◽  
Christopher E. Mandigo

Spine ◽  
1989 ◽  
Vol 14 (1) ◽  
pp. 119-122 ◽  
Author(s):  
DONALD S. SOLONIUK ◽  
SALVATORE R. PECORARO ◽  
FREDERICK E. MUNSCHAUER

2017 ◽  
Vol 11 (4) ◽  
pp. 299-301 ◽  
Author(s):  
Isabel Tulloch ◽  
James T Laban ◽  
Andrew J Martin

We present a patient with prostate cancer with vertebral metastases who developed spastic paraparesis secondary to spinal epidural lipomatosis (SEL) after receiving androgen deprivation therapy (ADT). We propose a link between ADT, metastatic prostate cancer and SEL.


2019 ◽  
Vol 126 ◽  
pp. e33-e40 ◽  
Author(s):  
Christopher Graham Kellett ◽  
Vino Siva ◽  
Irena Claudine Fiorina Norman ◽  
Josephine Jung ◽  
Gordan Grahovac ◽  
...  

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