• Shinichi Ishihara, Nobuyuki Fujita, Koichiro Azuma, Takehiro Michikawa, Mitsuru Yagi, Takashi Tsuji, Michiyo Takayama, Hideo Matsumoto, Masaya Nakamura, Morio Matsumoto, and Kota Watanabe.
• Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo 160-8582, Japan; Department of Orthopaedic Surgery, International University of Health and Welfare (IUHW), Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo 108-8329, Japan.
• Spine J. 2019 Mar 1; 19 (3): 493-500.

Background ContextSpinal epidural lipomatosis (SEL) is a condition in which excess lumbar epidural fat (EF) deposition often leads to compression of the cauda equina or nerve root. Although SEL is often observed in obese adults, no systematic research investigating the potential association between SEL and metabolic syndrome has been conducted.PurposeTo elucidate potential association between SEL and metabolic syndrome.Study DesignAn observational study used data of a medical checkup.Patient SampleWe retrospectively reviewed data from consecutive subjects undergoing medical checkups. A total of 324 subjects (174 men and 150 women) were enrolled in this study.Outcome MeasuresThe correlation of EF accumulation with demographic data and metabolic-related factors was evaluated.MethodsThe degree of EF accumulation was evaluated based on the axial views of lumbar magnetic resonance imaging. Visceral and subcutaneous fat areas were measured at the navel level using abdominal computed tomography. Metabolic syndrome was diagnosed according to the criteria of the Japanese Society of Internal Medicine. The correlation of SEL with metabolic syndrome and metabolic-related conditions was statistically evaluated.ResultsThe degree of EF accumulation demonstrated a significant correlation to body mass index, abdominal circumference, and visceral fat area. However, age, body fat percentage, and subcutaneous fat area showed no correlation with the degree of EF accumulation. Logistic regression analysis revealed that metabolic syndrome (odds ratio [OR]=3.8, 95% confidence interval [CI]=1.5-9.6) was significantly associated with SEL. Among the diagnostic criteria for metabolic syndrome, visceral fat area ≥100 cm2 (OR=4.8, 95% CI=1.5-15.3) and hypertension (OR=3.5, 95% CI=1.1-11.8) were observed to be independently associated with SEL.ConclusionThis is the first study to demonstrate that metabolic syndrome is associated with SEL in a relatively large, unbiased population. Our data suggest that metabolic-related conditions are potentially related to EF deposition and that SEL could be a previously unrecognized manifestation of metabolic syndrome.Copyright © 2018 Elsevier Inc. All rights reserved.

25 keywords...

hide…