Minimally invasive treatment of lumbar epidural lipomatosis with local administration of deoxycholic acid

Abstract

Lumbar epidural lipomatosis (LEL) is a rare neurologic condition characterized by the accumulation of adipose tissue in the spinal canal, leading to nerve root or spinal cord compression and necessitating subsequent surgical decompression in severe cases. We hypothesize that minimally invasive injection of deoxycholic acid (DCA), a medication used for submental fat reduction, may reduce epidural adipose tissue burden, decompress the nerve roots and spinal cord, and reduce symptoms associated with LEL. We propose a phase 1 clinical trial to investigate the safety of DCA injections in patients with LEL. In support of the mechanism of our hypothesis, previous studies have demonstrated that DCA disrupts adipocyte cell membranes, promoting tissue remodeling and reducing adipose tissue volume. DCA injections may represent a viable alternative to surgical decompression, reducing procedural risks to patients as well as decreasing recovery times and healthcare utilization.