• M Payer, P Van Schaeybroeck, A Reverdin, and D May.
• Department of Neurosurgery, University Hospital of Geneva, Switzerland.
• Acta Neurochir (Wien). 2003 Apr 1; 145 (4): 315-20; discussion 321.

BackgroundSymptomatic spinal epidural lipomatosis (SEL) of the lumbar spine is a rare disease, often associated with steroid overload. Idiopathic lipomatosis is even much less frequent. Signs and symptoms depend upon the level and degree of nerve root compression. Diagnosis is best based on MRI. Weight reduction can be curative, however after failure of medical treatment or in severe cases surgical decompression should be performed.MethodFour patients with severe symptoms of lumbar spinal epidural lipomatosis were treated by surgical decompression. Patient history and neurological examination are described, diagnostic imaging is demonstrated, surgical treatment and outcome are documented. Different surgical techniques including laminectomy, interlaminar fenestration and lateral recess decompression were applied and are discussed.FindingsAll four patients improved after surgery. No surgical complications were observed. Even though limited to four cases this is the second largest series of operated idiopathic spinal epidural lipomatosis.InterpretationSurgical decompression was effective in improving symptoms in severe lumbar idiopathic spinal epidural lipomatosis.

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