Postpartum Spinal Epidural Lipomatosis With Epidural Venous Engorgement
1Anesthesiology and Critical Care, University of Illinois College of Medicine Peoria, Peoria, USA.
Cureus
|October 16, 2023
Summary
Spinal epidural lipomatosis (SEL), abnormal fat growth in the spine, can cause neurological symptoms. This case highlights successful surgical decompression for acute leg weakness due to SEL.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Spinal epidural lipomatosis (SEL) involves abnormal fatty tissue growth outside the spinal canal.
- SEL can cause symptoms like back pain and radiculopathy, often linked to steroid use, obesity, or Cushing's syndrome.
- SEL symptoms can mimic other spinal conditions, including spinal stenosis and epidural hematoma.
Observation:
- A 34-year-old obese female presented with sudden left lower extremity weakness post-vaginal delivery with epidural analgesia.
- MRI revealed thoracic and lumbar spinal cord compression from posterior epidural lipomatosis and venous engorgement.
Findings:
- Immediate laminectomy at T3, T5, T7, and T9 relieved spinal cord compression.
- The patient experienced gradual recovery of muscle strength post-surgery.
Implications:
- This case demonstrates that SEL can present acutely, even postpartum.
- Surgical decompression is an effective treatment for symptomatic SEL causing neurological deficits.
- Prompt diagnosis and intervention are crucial for favorable outcomes in spinal cord compression cases.
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