Minimally Invasive Excision of Lumbar Epidural Lipomatosis Using a Spinal Endoscope

Abstract

In this report, we describe the case of a patient with a long-term radiculopathy due to epidural lipomatosis at the L3-4 intervertebral disc level. The fatty tissue was located on the dorsal side of the dural sac in the spinal canal and compressed the dural sac. The fatty tissue was removed endoscopically. After surgery, the symptoms disappeared, and neurological deficits normalized. We would like to state that epidural lipomatosis is a good candidate for minimally invasive endoscopic surgery because of its anatomic location.

Key words

endoscopic surgery - epidural lipomatosis - surgery

References

• 1 Fogel GR, Cunningham PY, Esses SI. Spinal epidural lipomatosis: case reports, literature review and meta-analysis.  Spine J.. 2005;  5 202-211
• 2 Borré DG, Borré GE, Aude F. et al . Lumbosacral epidural lipomatosis: MRI grading.  Eur Radiol. 2003;  13 1709-1721
• 3 Foley KT, Smith MM. Microendoscopic discectomy.  Techn Neurosurg. 1997;  3 301-307
• 4 Lisai P, Doria C, Crissantu L, Meloni GB. et al . Cauda equina syndrome secondary to idiopathic spinal epidural lipomatosis.  Spine. 2001;  26 307-309
• 5 Inui A, Sairyo K, Katoh S. et al . Extruded lumbar osseous endplate causing long-term radiculopathy in an adult: an endoscopic excision.  Minim Invas Neurosurg. 2006;  49 55-57
• 6 Hsieh PC, Wang CH. Posterior endoscopic lumbar discectomy using a thoracoport as a tubular retractor.  Minim Invas Neurosurg. 2004;  47 319-323
• 7 Perez-Cruet MJ, Foley KT, Isaacs RE. et al . Microendoscopic lumbar discectomy: technical note.  Neurosurgery. 2002;  51 ((5 Suppl)) S129-136
• 8 Sairyo K, Katoh S, Sakamaki T. et al . A new endoscopic technique to decompress lumbar nerve root affected by lumbar spondylolysis.  J Neurosurg. 2003;  98 ((3 Suppl)) 290-293
• 9 Yabuki S, Kikuchi S. Endoscopic partial laminectomy for cervical myelopathy.  J Neurosurg Spine. 2005;  2 170-174
• 10 Sairyo K, Goel VK, Masuda A. et al . Biomechanical rationale of endoscopic decompression for lumbar spondylolysis as an effective minimally invasive procedure - A study based on the finite element analysis.  Minim Invas Neurosurg. 2005;  48 119-122

Correspondence