Minimal Approach to Spinal Epidural Lipomatosis Using the Japanese Step Ladder Technique: A New Technique in 2 Cases

Abstract

Introduction: Spinal epidural lipomatosis (SEL) refers to a pathological condition characterized by an abnormal accumulation of fat within the epidural space. It’s a rare but well-known condition, that is mostly associated with long-term corticosteroid therapy or elevation of endogenous steroids. Objectives: We aim to present a comprehensive account of our experience with SEL, while also introducing a novel technique and its outcomes. Our approach is informed by a rigorous review of the relevant literature. Results: We report 2 cases of lipomatosis seen in the neurosurgery department. The first was a case of SEL due to obesity, manifested by intermittent claudication. The second case followed a lumbar arthrodesis, with clinical signs associated with radiculopathy. Both patients were treated conservatively, with no improvement, after which we opted for surgical treatment. The postoperative evolution of the 2 cases was marked by regression of symptoms in both patients.