Artikel
Long-term results after microsurgical decompression of patient with epidural spinal lipomatosis compared to classical lumbar spinal stenosis
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Autoren
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Simon Bayerl
- Charité - Universitätsmedizin Berlin, Klinik für Neurochirurgie, Berlin, Deutschland
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Tobias Finger
- Charité - Universitätsmedizin Berlin, Klinik für Neurochirurgie, Berlin, Deutschland
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Florian Pöhlmann
- Charité - Universitätsmedizin Berlin, Klinik für Neurochirurgie, Berlin, Deutschland
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Vincent Prinz
- Charité - Universitätsmedizin Berlin, Klinik für Neurochirurgie, Berlin, Deutschland
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Peter Vajkoczy
- Charité - Universitätsmedizin Berlin, Klinik für Neurochirurgie, Berlin, Deutschland
| Veröffentlicht: | 18. Juni 2018 |
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Gliederung
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Objective: The Spinal epidural lipomatosis (SEL) is a rare disease, but can result in a narrowing of the spinal canal and cause sciatica or neurological deficits as the classical osteo-ligamentous spinal canal stenosis. A microsurgical decompression can be performed, if the conservative treatment fails. However, there is only scares data concerning the outcome of surgical decompression in patients with SEL. The aim of this study was to illustrate the long-term outcome of patients with SEL treated via decompression surgery. Further the results were compared to patients with classical spinal stenosis.
Methods: Preoperative data of patients with SEL (SEL group, n=27) were analyzed retrospectively and the follow-up investigation was performed prospectively. The Oswestry Disability Index (ODI), Numeric Pain Rating Scale (NPRS), Roland and Morris Disability Questionnaire (RMDQ), the Short-form 36 score (SF-36) and the walking distance in a three year follow-up were collected to illustrate the clinical outcome. The outcome scores were compared to those of patients with classical lumbar spinal stenosis (CSS group, n=50), who have been matched concerning age, gender, and spino-pelvic parameters.
Results: Patients with SEL improved significantly after surgical decompression even after three years of follow-up. The outcome was comparable to the results of the CSS group concerning back and leg pain, as well as pain associated disability and quality of life (NPRS back SELg preop.= 6.4; NPRS back CSSg preop.= 6.7; NPRS back SELg 3-year= 3.5; NPRS back CSSg 3-year= 3.8; NPRS leg SELg preop.= 7.2; NPRS leg CSSg preop.= 6.7; NPRS leg SELg 3-year= 3.6; NPRS leg CSSg 3-year= 3.1; ODI SELg preop.=57; ODI CSSg preop=53.; ODI SELg 3-year=35; ODI CSSg 3-year=31). Both groups presented with a high level of patient satisfaction in the long term period (72% in SELg; 68% in CSSg).
Conclusion: If a symptomatic SEL is not accessible to conservative treatment, a microsurgical decompression represents an effective alternative treatment. The surgical procedure can be recommended due to its low risk profile and good clinical long-term results, that are similar to patients with a classical spinal stenosis.
