Chan Jun-Yeen, Chang Chih-Ju, Jeng Chin-Ming, Huang Shih-Hung, Liu Yuan-Kai, Huang Jing-Shan
Department of Neurosurgery, Cathay General Hospital, Taipei, Taiwan (R.O.C.).
Chang Gung Med J. 2009 Nov-Dec;32(6):662-7.
Spinal epidural lipomatosis (SEL), an abnormal localized or tumor-like accumulation of fat in the epidural space, is an infrequent complication of chronic steroid usage and an uncommon cause of spinal cord compression. During the period of 1990 to 2006, we have two cases of medically heath SEL patients without history of steroid administration. Their initial clinical manifestations were low back pain, progressive lower extremities weakness, numbness, followed by rapid deterioration of neurogenic intermittent claudication. They were misdiagnosed and treated as degenerative spinal disease for a long time. Due to prominent neurological deficit, lumbar magnetic resonance image (MRI) was obtained and showed SEL. These 2 patients all underwent laminectomy and removal of epidural fat. Postoperatively, they both showed improvement. We reviewed the literature and discussed the current concept in the management of SEL.
脊髓硬膜外脂肪增多症（SEL）是硬膜外间隙脂肪的异常局部或肿瘤样积聚，是慢性类固醇使用的罕见并发症及脊髓压迫的不常见原因。在1990年至2006年期间，我们有两例无类固醇用药史的健康SEL患者。他们最初的临床表现为腰痛、下肢进行性无力、麻木，随后神经源性间歇性跛行迅速恶化。他们长期被误诊并按退行性脊柱疾病治疗。由于明显的神经功能缺损，进行了腰椎磁共振成像（MRI）检查，结果显示为SEL。这2例患者均接受了椎板切除术并切除了硬膜外脂肪。术后，他们的症状均有改善。我们回顾了文献并讨论了SEL治疗的当前理念。
