Katsuhiro Tofuku
We present two cases of idiopathic spinal epidural lipomatosis. Case 1: A 77-year-old man experienced tightness in bilateral lower extremities and neurogenic claudication for 1 year. He was overweight with a body mass index of 30.8 kg/m2. Magnetic resonance imaging revealed extensive epidural lipomatosis of lumobsacral spine with significant constrictive compression of the thecal sac. Case 2: A 78-year-old man presented with low back pain along with progressive pain and numbness in the left lower extremity and neurogenic claudication for 6 months. He was diabetic with body mass index of 25.6 kg/m2. Magnetic resonance imaging demonstrated circumferential compression of the thecal sac due to increased epidural fat tissue at the L4 level. We suggest that spinal epidural lipomatosis should be considered in the differential diagnoses when patients with neurological symptoms have conditions relating to hyperinsulinism such as obesity and exogenous steroid administration
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