Spinal Epidural Lipomatosis: a Case Report and Review of the Literature

NCT ID: NCT04622501

Last Updated: 2020-11-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

1 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-06-10

Study Completion Date

2020-06-10

Brief Summary

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Introduction Lumbar spinal epidural lipomatosis (SEL) is a rare condition defined by an excessive deposition of adipose tissue in the lumbar spinal canal. The objective of this case report is to document a clinical case of SEL presenting within a multidisciplinary spine clinic and to compare our clinical findings and management with the current literature.

Case presentation A 51-year-old female presented at a spine clinic with low back pain, bilateral leg pain and difficulty walking. MR imaging of the lumbar spine showed L4-L5 and L5-S1 degenerative disk disease with evidence of severe central canal stenosis due to extensive epidural lipomatosis. The patient was initially advised to lose weight, undergo a course of physiotherapy, and consult with the pain clinic. Because of lack of improvement, the patient was scheduled for L4-S1 posterior spinal decompression and L4-L5 posterior spinal instrumented fusion.

Discussion The discussion will include the diagnosis of SEL, imaging appearance, its risk factors, etiology and management.

Conclusion This case report describes a case of lumbar spinal stenosis due to SEL with neurological symptoms. Some risk factors have also been identified in the literature. MRI is considered as the reference standard for its diagnosis. The therapeutic approach of patients with SEL is not standardized. Thus, reporting and investigating the diagnostic process and treatment of this patient will positively contribute to better management for other future patients.

Detailed Description

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Conditions

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Spinal Stenosis

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

CROSS_SECTIONAL

Interventions

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posterior spinal decompression and posterior spinal instrumented fusion

posterior spinal decompression and posterior spinal instrumented fusion performed on a patient with Spinal Epidural Lipomatosis

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Adults patient with a clinical diagnosis of Spinal Epidural Lipomatosis (MRI and clinical diagnosis)

Exclusion Criteria

* Absence of clinical diagnosis of Spinal Epidural Lipomatosis
Minimum Eligible Age

18 Years

Maximum Eligible Age

100 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Canadian Memorial Chiropractic College

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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CMCC

Toronto, Ontario, Canada

Site Status

Countries

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Canada

References

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Borre DG, Borre GE, Aude F, Palmieri GN. Lumbosacral epidural lipomatosis: MRI grading. Eur Radiol. 2003 Jul;13(7):1709-21. doi: 10.1007/s00330-002-1716-4. Epub 2002 Dec 13.

Reference Type BACKGROUND
PMID: 12835988 (View on PubMed)

Fogel GR, Cunningham PY 3rd, Esses SI. Spinal epidural lipomatosis: case reports, literature review and meta-analysis. Spine J. 2005 Mar-Apr;5(2):202-11. doi: 10.1016/j.spinee.2004.05.252.

Reference Type BACKGROUND
PMID: 15795966 (View on PubMed)

Agha RA, Borrelli MR, Farwana R, Koshy K, Fowler AJ, Orgill DP; SCARE Group. The SCARE 2018 statement: Updating consensus Surgical CAse REport (SCARE) guidelines. Int J Surg. 2018 Dec;60:132-136. doi: 10.1016/j.ijsu.2018.10.028. Epub 2018 Oct 18.

Reference Type BACKGROUND
PMID: 30342279 (View on PubMed)

Fassett DR, Schmidt MH. Spinal epidural lipomatosis: a review of its causes and recommendations for treatment. Neurosurg Focus. 2004 Apr 15;16(4):E11.

Reference Type BACKGROUND
PMID: 15191340 (View on PubMed)

Theyskens NC, Paulino Pereira NR, Janssen SJ, Bono CM, Schwab JH, Cha TD. The prevalence of spinal epidural lipomatosis on magnetic resonance imaging. Spine J. 2017 Jul;17(7):969-976. doi: 10.1016/j.spinee.2017.02.010. Epub 2017 Mar 3.

Reference Type BACKGROUND
PMID: 28263890 (View on PubMed)

Yildirim B, Puvanesarajah V, An HS, Novicoff WM, Jain A, Shen FH, Hassanzadeh H. Lumbosacral Epidural Lipomatosis: A Retrospective Matched Case-Control Database Study. World Neurosurg. 2016 Dec;96:209-214. doi: 10.1016/j.wneu.2016.08.125. Epub 2016 Sep 5.

Reference Type BACKGROUND
PMID: 27609448 (View on PubMed)

Kim K, Mendelis J, Cho W. Spinal Epidural Lipomatosis: A Review of Pathogenesis, Characteristics, Clinical Presentation, and Management. Global Spine J. 2019 Sep;9(6):658-665. doi: 10.1177/2192568218793617. Epub 2018 Aug 13.

Reference Type BACKGROUND
PMID: 31448201 (View on PubMed)

Malone JB, Bevan PJ, Lewis TJ, Nelson AD, Blaty DE, Kahan ME. Incidence of spinal epidural lipomatosis in patients with spinal stenosis. J Orthop. 2017 Nov 6;15(1):36-39. doi: 10.1016/j.jor.2017.11.001. eCollection 2018 Mar.

Reference Type BACKGROUND
PMID: 29203971 (View on PubMed)

Walchli B, Benini A. Spinal epidural lipomatosis. Swiss Med Wkly. 2001 Jun 16;131(23-24):359. doi: 10.4414/smw.2001.09739. No abstract available.

Reference Type BACKGROUND
PMID: 11486570 (View on PubMed)

Ferlic PW, Mannion AF, Jeszenszky D, Porchet F, Fekete TF, Kleinstuck F, Haschtmann D. Patient-reported outcome of surgical treatment for lumbar spinal epidural lipomatosis. Spine J. 2016 Nov;16(11):1333-1341. doi: 10.1016/j.spinee.2016.06.022. Epub 2016 Jun 27.

Reference Type BACKGROUND
PMID: 27363757 (View on PubMed)

Other Identifiers

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202015

Identifier Type: -

Identifier Source: org_study_id