Spinal epidural lipomatosis

Case contributed by Utkarsh Kabra
Diagnosis almost certain

Presentation

Backache, past history of left hip surgery following accident.

Patient Data

Age: 65 years
Gender: Male

Lumbar spine

mri

Grade I anterolisthesis of L5 over S1 vertebra body is seen. Concentric bulge of L5-S1 disc is seen with facet arthropathy, mildly impinging on central canal and bilateral neural foramina.

Case Discussion

Prominent epidural fat from L4 to S1 level causing compression of cauda equina nerve roots, consistent with epidural lipomatosis. The cauda equina roots assume a 'Y' shape, the so called 'Y' sign of epidural lipomatosis.

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