Al-Khawaja Darweesh, Seex Kevin, Eslick Guy D
Department of Neurosurgery, Wollongong Hospital, Wollongong, New South Wales, Australia.
J Clin Neurosci. 2008 Dec;15(12):1323-6. doi: 10.1016/j.jocn.2008.03.001. Epub 2008 Oct 26.
Spinal epidural lipomatosis (SEL) is a rare disorder characterized by overgrowth of fat in the extradural space, causing compression of the neural elements. It is frequently associated with the administration of exogenous steroids or elevation of endogenous steroids. We present two patients, both with epidural lipamotosis of idiopathic origin. One was 53-year-old man with progressive mid-thoracic and lower limb pain with associated weakness and neurogenic claudication due to thoracic epidural lipomatosis. The second was a 68-year-old male with lumbar epidural lipomatosis. Co-morbidities for the first patient included diabetes and obesity; however, there was no history of steroid administration. An MRI scan revealed thoracic cord compression, with significant stenosis at T4-T9. The second patient complained of progression of longstanding lumbar pain and claudicant symptoms. There was no history of steroid intake. An MRI revealed stenosis at L4-S1 and diffuse anterior lipomatosis. A literature review revealed 49 cases of idiopathic SEL and 62 of secondary SEL. We aimed to delineate the differences between these two relatively distinct entities including their anatomical distribution, clinical presentation and prognostic implications.
脊髓硬膜外脂肪增多症（SEL）是一种罕见的疾病，其特征是硬膜外间隙脂肪过度生长，导致神经组织受压。它常与外源性类固醇的使用或内源性类固醇水平升高有关。我们报告两名患者，均为特发性起源的硬膜外脂肪增多症。一名是53岁男性，因胸段硬膜外脂肪增多症出现进行性胸中部及下肢疼痛，并伴有无力和神经源性间歇性跛行。第二名是一名68岁男性，患有腰椎硬膜外脂肪增多症。第一名患者的合并症包括糖尿病和肥胖；然而，他没有使用类固醇的病史。磁共振成像（MRI）扫描显示胸段脊髓受压，T4 - T9处有明显狭窄。第二名患者主诉长期腰痛和间歇性跛行症状加重。他没有类固醇摄入史。MRI显示L4 - S1处狭窄及弥漫性前部脂肪增多症。文献综述显示，有49例特发性SEL病例和62例继发性SEL病例。我们旨在阐明这两个相对不同的实体之间的差异，包括它们的解剖分布、临床表现和预后意义。
