Shinichi Ishihara1,2,3, Nobuyuki Fujita1,3, Mitsuru Yagi1,3, Takashi Tsuji3,4, Takehiro Michikawa5, Yuji Nishiwaki6, Yasuyuki Fukui1,3, Keisuke Horiuchi1,7, Ken Ishii1,2,3,8, Masaya Nakamura1,3, Morio Matsumoto1,3, Kota Watanabe1,3. 1. Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan. 2. Department of Orthopaedic Surgery, International University of Health and Welfare (IUHW), Mita Hospital, Tokyo, Japan. 3. Keio Spine Research Group (KSRG), Tokyo, Japan. 4. Department of Orthopaedic Surgery, Fujita Health University, Aichi, Japan. 5. Environmental Epidemiology Section, Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan. 6. Department of Preventive Medicine and Public Health, Toho University School of Medicine, Tokyo, Japan. 7. Department of Orthopedic Surgery, National Defense Medical College, Tokorozawa, Japan. 8. Department of Orthopaedic Surgery, International University of Health and Welfare (IUHW), School of Medicine, Chiba, Japan.
Abstract
STUDY DESIGN: Single-center retrospective analysis of consecutively collected data. OBJECTIVE: To determine the clinical characteristics of idiopathic spinal epidural lipomatosis (SEL). SUMMARY OF BACKGROUND DATA: SEL is associated with the overt accumulation of nonencapsulated adipose tissue in the epidural space, leading to spinal cord or nerve root compression. The etiology of this condition is currently not completely understood. METHODS: Data of 166 male patients who underwent primary surgery for lumbar spinal canal stenosis (LSS) from May 2013 to February 2016 were retrospectively reviewed. Participants were divided into three groups based on the degree of epidural lipomatous lesion. Patient data of age at surgery, body mass index, prevalence of common noncommunicable diseases, blood tests, arteriosclerotic index, and preoperative clinical scores (assessed using the Japanese Orthopedic Association Back Pain Evaluation Questionnaire) were evaluated. Multivariate analysis was performed to assess the potential associated factors for idiopathic SEL. RESULTS: Patients with LSS with severe SEL had a significantly higher body mass index and elevated serum levels of total cholesterol and triglyceride compared with those without SEL. Analysis of preoperative clinical scores revealed that patients with SEL experienced pain more frequently and showed less walking ability than did those without SEL. Multivariate analysis revealed that hyperlipidemia was significantly associated with idiopathic SEL (odds ratio = 3.74, 95% confidence interval = 1.31-10.64). CONCLUSION: Our data suggest that aberrant lipid metabolism is related to the pathogenesis of idiopathic SEL and that patients with LSS with idiopathic SEL have more severe pain than do those without SEL. LEVEL OF EVIDENCE: 3.
STUDY DESIGN: Single-center retrospective analysis of consecutively collected data. OBJECTIVE: To determine the clinical characteristics of idiopathic spinal epidural lipomatosis (SEL). SUMMARY OF BACKGROUND DATA: SEL is associated with the overt accumulation of nonencapsulated adipose tissue in the epidural space, leading to spinal cord or nerve root compression. The etiology of this condition is currently not completely understood. METHODS: Data of 166 male patients who underwent primary surgery for lumbar spinal canal stenosis (LSS) from May 2013 to February 2016 were retrospectively reviewed. Participants were divided into three groups based on the degree of epidural lipomatous lesion. Patient data of age at surgery, body mass index, prevalence of common noncommunicable diseases, blood tests, arteriosclerotic index, and preoperative clinical scores (assessed using the Japanese Orthopedic Association Back Pain Evaluation Questionnaire) were evaluated. Multivariate analysis was performed to assess the potential associated factors for idiopathic SEL. RESULTS:Patients with LSS with severe SEL had a significantly higher body mass index and elevated serum levels of total cholesterol and triglyceride compared with those without SEL. Analysis of preoperative clinical scores revealed that patients with SEL experienced pain more frequently and showed less walking ability than did those without SEL. Multivariate analysis revealed that hyperlipidemia was significantly associated with idiopathic SEL (odds ratio = 3.74, 95% confidence interval = 1.31-10.64). CONCLUSION: Our data suggest that aberrant lipid metabolism is related to the pathogenesis of idiopathic SEL and that patients with LSS with idiopathic SEL have more severe pain than do those without SEL. LEVEL OF EVIDENCE: 3.
Authors: Steven T Papastefan; Abhiraj D Bhimani; Steven Denyer; Sajeel R Khan; Darian R Esfahani; Demetrios C Nikas; Ankit I Mehta Journal: Childs Nerv Syst Date: 2017-12-22 Impact factor: 1.475