ENDOSCOPIC SUCTION DECOMPRESSION OF IDIOPATHIC EPIDURAL LIPOMATOSIS

BACKGROUND Epidural lipomatosis can be idiopathic or associated with o besity and steroid excess. This disorder can be treated by weight cont rol, reduction of steroid load, or operative decompression. We describ e a non-obese patient with neurogenic claudication who had localized e pidural fat from L4 to S1. Minimally invasive treatment consisted of a small laminotomy and endoscopically guided fat aspiration. METHODS A small bilateral L5-S1 laminotomy was performed. Using a special mallea ble endoscopic aspirator, loose fat was removed both dorsal and ventra l to the dural sac. RESULTS At surgery, endoscopically guided suction aspiration was successful in removing the majority of the fat. Areas o f fat that were vascularized and adherent to the dura required microsu rgical dissection. Postoperatively, the patient has been asymptomatic. CONCLUSIONS This minimally invasive technique was successful in treat ing epidural dual compression that had failed conservative measures. F urther evaluation of this technology is warranted. (C) 1998 by Elsevie r Science Inc.