Spinal epidural lipomatosis: a complication of glucocorticoid therapy

A 21-year-old woman receiving prolonged high dosage glucocorticoids developed spinal cord compression due to excessive accumulation of epidural fat. Computerized tomographic scanning confirmed the diagnosis and revealed a peculiar pattern of spinal cord displacement which we believe to be unique to compression by fat. Laminectomy did not afford relief, possibly because of prolonged neural compression or because of compression at a higher spinal level. Although an unusual complication of Cushing's syndrome, epidural lipomatosis should be considered when such a patient develops symptoms of spinal cord or cauda equina compression.