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Epidural lipomatosis

Epidural lipomatosis refers to excessive accumulation of fat within the spinal epidural space, such that the thecal sac is compressed.

Clinical presentation

Patients may present with back pain resembling that of a disc herniation. In severe cases, symptoms of canal stenosis are produced.

Pathology

Characterized by the abnormal accumulation of unencapsulated adipose tissue in the extradural space.

Causes
Location

Typically involves the lower lumbar and/or lower thoracic levels.

Radiographic features

MRI spine

There is a often generalised excess of fat seen in the extradural space. As a result the dural sac can appear narrowed or even resemble a "Y" shaped configuration.

Signal characteristics follow fat on all sequences:

  • T1: high signal
  • T1 (FS): shows fat suppression
  • T2: high signal

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