Epidural lipomatosis

Epidural lipomatosis refers to an 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.


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


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

Radiographic features

MRI spine

There is an 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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