Lim Mervyn Jun Rui, Zheng Yilong, Babla Singbal Salil, Makmur Andrew, Yeo Tseng Tsai, Kumar Naresh
Division of Neurosurgery, National University Health System, Singapore.
Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
J Clin Orthop Trauma. 2022 Aug 13;32:101988. doi: 10.1016/j.jcot.2022.101988. eCollection 2022 Sep.
The epidemiology and clinical characteristics of spinal epidural lipomatosis (SEL) have been well-reported in the literature. However, few studies investigated the concomitant spinal pathologies that were present in patients with SEL. Therefore, we aimed to summarize the clinical and radiological characteristics of patients with SEL diagnosed on spinal imaging.
Patients who were diagnosed with SEL on magnetic resonance imaging from January 2018 to October 2020 at our institution were included in the study. Clinical data was collected using a standardized data collection form. SEL was graded using a modified version of the Borré grading system. Factors associated with moderate or severe SEL were determined using multiple logistic regression.
A total of 90 patients were included in the analysis. The mean (±SD) age was 59.3 (±17.1) years, and 62 patients (68.9%) were male. 61 patients (67.8%) had moderate or severe SEL. Most patients were overweight or obese (57 patients, 63.3%). The most common presenting symptoms was back pain (57 patients, 63.3%). SEL was diagnosed incidentally in 42 patients (46.7%). The lumbar spine was the most common site of SEL (35 patients, 38.9%). The most common concomitant spinal pathologies were disc bulge (83 patients, 92.2%) and flavum hypertrophy (60 patients, 66.7%). Moderate or severe SEL was associated with WHO Obesity Class, back pain or radicular leg pain at first presentation, and SEL that was worst at the lumbar or lumbosacral spinal level.
Moderate or severe SEL were independently associated with WHO Obesity Class, back pain, radicular leg pain, and SEL that was worst at the lumbar or lumbosacral spinal level. Future studies should prospectively evaluate whether weight loss therapy is warranted in patients with SEL.
脊柱硬膜外脂肪增多症（SEL）的流行病学和临床特征在文献中已有充分报道。然而，很少有研究调查SEL患者同时存在的脊柱病变。因此，我们旨在总结经脊柱影像学诊断为SEL的患者的临床和放射学特征。
纳入2018年1月至2020年10月在我院经磁共振成像诊断为SEL的患者。使用标准化数据收集表收集临床数据。SEL采用改良的Borré分级系统进行分级。采用多元逻辑回归确定与中度或重度SEL相关的因素。
共90例患者纳入分析。平均（±标准差）年龄为59.3（±17.1）岁，62例（68.9%）为男性。61例（67.8%）患者为中度或重度SEL。大多数患者超重或肥胖（57例，63.3%）。最常见的症状是背痛（57例，63.3%）。42例（46.7%）患者SEL为偶然发现。腰椎是SEL最常见的部位（35例，38.9%）。最常见的同时存在的脊柱病变是椎间盘膨出（83例，92.2%）和黄韧带肥厚（60例，66.7%）。中度或重度SEL与世界卫生组织肥胖分级、初次就诊时的背痛或放射性腿痛以及腰椎或腰骶部脊柱水平最严重的SEL相关。
中度或重度SEL与世界卫生组织肥胖分级、背痛、放射性腿痛以及腰椎或腰骶部脊柱水平最严重的SEL独立相关。未来的研究应前瞻性评估SEL患者是否有必要进行减肥治疗。
