Greenish Davyd, Watura Karen, Harding Ian
Medicine, Taunton and Somerset NHS Foundation Trust, Taunton, Somerset, UK.
North Bristol NHS Trust, Bristol, UK.
BMJ Case Rep. 2019 Feb 15;12(2):e226985. doi: 10.1136/bcr-2018-226985.
A 73-year-old man underwent bilateral spinal decompression of L4/5 for severe spinal canal stenosis, requiring minimal analgesia and providing immediate relief. Two days post-operatively, he presented with new onset bilateral leg pain and difficulty mobilising. MRI demonstrated spinal epidural lipomatosis (SEL), which was not present pre-operatively, at L5/S1. Further surgery was performed with decompression of L5/S1 through removal of epidural fat. At both 3 weeks and 5 months follow-up clinics, the patient was asymptomatic. To our knowledge, this is the first case of acute spinal epidural lipomatosis directly following spinal surgery. It is important to recognise SEL as a complication following spinal surgical intervention, due to the potential development of significant neurological consequences.
一名73岁男性因严重椎管狭窄接受了L4/5双侧脊柱减压手术，所需镇痛药物极少，术后疼痛立即缓解。术后两天，他出现新发双侧腿痛及活动困难。磁共振成像（MRI）显示L5/S1水平存在术前未出现的脊髓硬膜外脂肪增多症（SEL）。通过切除硬膜外脂肪对L5/S1进行减压，再次进行了手术。在术后3周和5个月的随访门诊中，患者均无症状。据我们所知，这是首例脊柱手术后直接发生急性脊髓硬膜外脂肪增多症的病例。鉴于可能会出现严重的神经后果，认识到SEL是脊柱手术干预后的一种并发症很重要。
