Spinal epidural lipomatosis following bilateral spinal decompression surgery

Area of Science:

• Neurosurgery
• Spinal Surgery
• Radiology

Background:

• Spinal canal stenosis is a common condition often treated with surgical decompression.
• Spinal epidural lipomatosis (SEL) is characterized by excessive fat accumulation in the epidural space.
• Post-operative complications following spinal surgery require careful monitoring and management.

Observation:

• A 73-year-old male presented with new-onset bilateral leg pain and mobility issues two days after L4/5 spinal decompression surgery.
• Magnetic Resonance Imaging (MRI) revealed acute spinal epidural lipomatosis (SEL) at L5/S1, not previously detected.
• The patient's symptoms significantly impacted his ability to mobilize.

Findings:

• Surgical decompression by removing epidural fat at L5/S1 successfully treated the acute SEL.
• The patient experienced immediate symptom relief and remained asymptomatic at 3 weeks and 5 months post-operatively.
• This case represents the first documented instance of acute SEL directly following spinal surgical intervention.

Implications:

• Spinal epidural lipomatosis (SEL) should be recognized as a potential complication after spinal surgery.
• Early diagnosis and surgical management of post-operative SEL are crucial to prevent neurological deficits.
• Awareness among surgeons regarding this rare complication can improve patient outcomes.