Sandberg D I, Lavyne M H
Division of Neurosurgery, Weill Medical College of Cornell University, New York Presbyterian Hospital, New York, USA.
Neurosurgery. 1999 Jul;45(1):162-5. doi: 10.1097/00006123-199907000-00037.
Spinal epidural lipomatosis, which causes symptomatic compression of neural elements, is a well known but uncommon complication of Cushing's syndrome. Spinal epidural lipomatosis has been reported frequently in association with chronic systemic corticosteroid therapy, but thus far only one case has been attributed to local epidural corticosteroid injections.
We report another case of symptomatic spinal epidural lipomatosis after epidural corticosteroid injections. This is the first such case documented by magnetic resonance imaging and confirmed with surgical exploration.
The patient's symptoms of neurogenic claudication resolved after lumbar laminectomy in the region of previous corticosteroid injections and the removal of epidural fat, which was compressing the thecal sac.
This case should alert clinicians that epidural lipomatosis, which causes symptomatic thecal sac compression, is a possible complication, not only of systemic glucocorticoid therapy, but also of local epidural corticosteroid injections.
脊髓硬膜外脂肪增多症可导致神经结构出现症状性压迫，是库欣综合征一种广为人知但并不常见的并发症。脊髓硬膜外脂肪增多症常与慢性全身性皮质类固醇治疗相关，但迄今为止仅有一例被认为是由局部硬膜外皮质类固醇注射所致。
我们报告了另一例硬膜外皮质类固醇注射后出现症状性脊髓硬膜外脂肪增多症的病例。这是首例经磁共振成像记录并经手术探查证实的此类病例。
患者的神经源性间歇性跛行症状在先前皮质类固醇注射区域行腰椎椎板切除并清除压迫硬膜囊的硬膜外脂肪后得到缓解。
该病例应提醒临床医生，导致硬膜囊出现症状性压迫的硬膜外脂肪增多症不仅是全身性糖皮质激素治疗的一种可能并发症，也是局部硬膜外皮质类固醇注射的一种可能并发症。
