Alonge Emmanuel O, Guo Chaofeng, Wang Yuxiang, Zhang Hongqi
Xiangya Hospital of Central South University, Changsha, Hunan Province, China.
Clin Spine Surg. 2023 Feb 1;36(1):1-7. doi: 10.1097/BSD.0000000000001290. Epub 2021 Dec 29.
Though both neurosurgeons and orthopedic spinal surgeons are keenly aware of the clinical importance of epidural fat (EF), surgical practice varies amongst individual surgeons and across both fields. Thus, an in-depth understanding of the anatomical structure and composition of EF is vital, as it will play a significant role in the therapeutic management and the surgical choice of treatment.
We aim to extensively review the anatomical and biological properties of EF and further outline the surgical importance of EF management.
(i) MEDLINE search 1966-July 2019. Keywords: Review of the Literature. Authorship, Meta-analysis, Descriptive/Narrative overview; (ii) CINAHL search from 1982 to May 2019. Keywords: Review of the Literature spinal epidural fat; Authorship; Meta-analysis; Descriptive/Narrative overview; (iii) Hand searches of the references of retrieved literature; (iv) Personal and college libraries were searched for texts on research methods and literature reviews; and (v) 200 articles were downloaded, 50 were excluded because of similarity of topics and also because of new update on the same topics. (vi) Discussions with experts in the field of reviews of the literature.
Though excessive or reductive amounts of EF usually exacerbates neurological symptoms and lead to various pathologic conditions such as spinal epidural lipomatosis, but there is no basic science, experimental, or clinical research that proves the role of EF in the aforementioned pathologic situations.
Anatomical illustration, biological function and properties of EF knowledge may lead to changes in the stages of the surgical approach to avoid postoperative complications. However, the role of EF is exclusively bound to a scientific hypothesis as one cannot be sure if an excessive or reductive amount in EF is entirely responsible for the pathologic findings, or just only an incidental finding.
尽管神经外科医生和骨科脊柱外科医生都敏锐地意识到硬膜外脂肪（EF）的临床重要性，但不同外科医生之间以及这两个领域的手术操作存在差异。因此，深入了解EF的解剖结构和组成至关重要，因为它将在治疗管理和手术治疗选择中发挥重要作用。
我们旨在广泛回顾EF的解剖和生物学特性，并进一步概述EF管理的手术重要性。
（i）1966年至2019年7月的MEDLINE搜索。关键词：文献综述。作者、荟萃分析、描述性/叙述性概述；（ii）1982年至2019年5月的CINAHL搜索。关键词：文献综述 脊柱硬膜外脂肪；作者；荟萃分析；描述性/叙述性概述；（iii）对检索文献的参考文献进行手工检索；（iv）在个人和学校图书馆中搜索关于研究方法和文献综述的文本；（v）下载了200篇文章，其中50篇因主题相似以及同一主题的新更新而被排除。（vi）与文献综述领域的专家进行讨论。
尽管EF过多或过少通常会加重神经症状并导致各种病理状况，如脊柱硬膜外脂肪增多症，但尚无基础科学、实验或临床研究证明EF在上述病理情况中的作用。
EF的解剖图示、生物学功能和特性知识可能会导致手术方法阶段的改变，以避免术后并发症。然而，EF的作用仅局限于一个科学假设，因为无法确定EF过多或过少是否完全是病理结果的原因，或者仅仅是一个偶然发现。
