Spinal epidural lipomatosis: Case reports, literature review and meta-analysis

Background context: Symptomatic spinal epidural lipomatosis (SEL), a rare cause of spinal cord compression, has most often been associated with exogenous steroid use. Purpose: Identify four associations with SE L, correlate the associated groups with level of disease and compare treatment with outcome data in these groups. Study design/setting: Case reports of three patients and analysis of 104 cases from the literature. Patient sample: Three patients from the senior author's practice. Outcome measures: Not applicable. Methods: The authors report three new cases of SEL not associated with steroid use. They review all available English literature and present a table of all 104 reported cases. Results: The clinical course of three new patients is reported. Conclusions: Associated conditions are exogenous steroid use, obesity, endogenous steroid excess, and some remain idiopathic. Although SEL is a rare condition, our review of the literature reveals many more reported cases than previously thought. With increased awareness of this condition and improved imaging techniques, further studies of this disease should be undertaken.