Alsofyani Mohammad A, Haignere Vincent, Alsalmi Sultan, Gille Olivier, Vital Jean-Marc, Pointillart Vincent, Boissière Louis, Obeid Ibrahim
Department of Spinal Surgery Unit, Bordeaux University Hospital, Bordeaux University, C.H.U Tripode Pellegrin, Place Amélie Raba Léon, 33076 Bordeaux, France.
Department of Orthopedics, College of Medicine and University Hospital, University of Hail, Hail City, Kingdom of Saudi Arabia.
Asian J Neurosurg. 2020 Feb 25;15(1):180-183. doi: 10.4103/ajns.AJNS_255_19. eCollection 2020 Jan-Mar.
Here, we report a case of idiopathic epidural lipomatosis presented with a clinical picture of lumbar canal stenosis with neurogenic claudication which resolved completely only by weight loss. A 53-year-old obese male with a body mass index of 36 without significant past medical history presented to the outpatient clinic with neurogenic claudication and bilateral sciatic radiculopathy. Initially, magnetic resonance imaging (MRI) showed epidural lipomatosis at the level of L5 vertebral body and L5-S1 intervertebral disc. A conservative treatment was decided with dietary regime program. After 6 months of follow-up, his bilateral sciatic radiculopathy disappeared, and updated MRI showed complete disappearance of epidural lipomatosis. Based on the Grand Round case and relevant literature, we present a case of an unusual epidural lipomatosis with mixed clinical picture of degenerative lumbar disease. This case report set out the importance of Borré classification for differentiating the mixed clinical complaint of degenerative discopathy and epidural lipomatosis.
在此，我们报告一例特发性硬膜外脂肪增多症，其临床表现为腰椎管狭窄伴神经源性间歇性跛行，仅通过体重减轻就完全缓解。一名53岁的肥胖男性，体重指数为36，既往无重大病史，因神经源性间歇性跛行和双侧坐骨神经神经根病就诊于门诊。最初，磁共振成像（MRI）显示L5椎体和L5-S1椎间盘水平存在硬膜外脂肪增多症。决定采用饮食方案进行保守治疗。随访6个月后，其双侧坐骨神经神经根病消失，更新后的MRI显示硬膜外脂肪增多症完全消失。基于本次病例讨论及相关文献，我们呈现一例具有退行性腰椎疾病混合临床表现的罕见硬膜外脂肪增多症病例。本病例报告阐述了Borré分类对于区分退行性椎间盘病和硬膜外脂肪增多症混合临床症状的重要性。
