Lipomatose epidural idiopática familiar: relato de três casos e revisão da literatura

Resumo

Lipomatose epidural é a doença causada pelo aumento da quantidade de gordura no espaço epidural da coluna vertebral, levando à compressão medular ou radicular. A medula toracolombar é a mais comumente envolvida. É geralmente encontrada em homens. As principais causas são a obesidade, altos níveis de corticoides exógenos ou endógenos e hipotireoidismo. A forma idiopática é rara, correspondendo a 17% dos casos. Manifesta-se como mielopatia compressiva ou das raízes da cauda equina. A ressonância magnética é o exame de escolha; sugere-se o diagnóstico quando a espessura da camada de gordura epidural ultrapassa 6 mm. Nós adotamos neste caso a laminectomia com ressecção da gordura epidural, citada como uma das possíveis formas de tratamento. A maioria dos trabalhos demonstra melhora gradual, acentuada ou completa, do déficit neurológico nos primeiros 2 anos após a cirurgia.

Abstract

Epidural lipomatosis is a disease caused by increased fat content in the epidural space of the spine, leading to root or spinal cord compression. The thoracolumbar spinal cord is the most commonly involved. It is usually found in men. The main causes are obesity, high levels of exogenous or endogenous steroids and hypothyroidism. The idiopathic form is rare, accounting for 17% of cases. It manifests as compressive myelopathy or radiculopathy. MRI is the test of choice, suggests the diagnosis when the thickness of the epidural fat exceeds 6mm. We adopt in this case laminectomy with fat resection, cited as one of the possible forms of treatment. Most studies show a gradual improvement, marked or complete neurological recovery in the first two years after surgery.

Palavras-Chave

lipomatosis - espinal - epidural - idiopática - paraparesia

Keywords

idiopathic - spinal - epidural - lipomatosis - paraparesis

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