Epidural lipomatosis

Case contributed by Frank Gaillard
Diagnosis certain

Presentation

Lumbar back pain

Patient Data

Age: 65 years
Gender: Female
mri

There is a grade I anterior spondylolisthesis of L4 with respect to L5 secondary to degenerative facet joint changes. No definite pars defects. Alignment of the lumbar spine is otherwise unremarkable. 

From the L4 to the S2 segment there is severe epidural lipomatosis contributing to thecal sac distortion and stenosis. 

Case Discussion

This case elegantly illustrates compression of the thecal sac into various configurations due to the variable location and number of epidural ligaments

Case courtesy of A/Prof DL Stella, Royal Melbourne Hospital. 

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