Abstract
BackgroundA previous study reported a high prevalence of spinal epidural lipomatosis (SEL) in patients with Scheuermann kyphosis (SK) and suggested that it may play a role in the pathogenesis of this disease. According to our observation, however, SEL occurs in other spinal kyphotic deformities as well. The aim of this study was to test the hypothesis that SEL commonly occurs in patients with different types of kyphotic deformities as a secondary intraspinal disorder.MethodsMR images of 16 patients with congenital kyphosis (CK), 40 patients with SK, 13 patients with tuberculotic kyphosis (TK), and 69 age- and sex-matched controls were retrospectively evaluated. The body mass index (BMI), kyphosis Cobb angle, and sagittal diameters of spinal epidural fat (EF) and the dural sac (DS) in the apical region (EFA, DSA) and non-kyphotic region (EFN, DSN) were measured. The EF ratios at the apical vertebral level (EFRA) and in the non-kyphotic region (EFRN) were calculated as EF / (EF + DS).ResultsEFA and EFRA were significantly higher among patients with CK, SK, and TK than among controls (P < 0.05). Seven CK patients (43.8%), 8 SK patients (20.0%), and 11 TK patients (84.6%) fulfilled the diagnostic criteria for SEL, while only 6.3, 2.5, and 0% of patients in the control groups did (P = 0.019, 0.014, and < 0.001, respectively). Spearman’s correlation analysis showed statistically significant correlations between the kyphosis Cobb angle and the amount of EF in all three patient groups.ConclusionsSEL is a common secondary intraspinal disorder in different types of kyphotic deformities, and surgeons should pay increased attention to this intraspinal anomaly because excessive EF may compress the spinal cord and cause neurological deficits.
Highlights
A previous study reported a high prevalence of spinal epidural lipomatosis (SEL) in patients with Scheuermann kyphosis (SK) and suggested that it may play a role in the pathogenesis of this disease
Abul-Kasim et al [6] reported an intriguing finding that epidural lipomatosis is a common comorbidity of Scheuermann disease, which is known as Scheuermann kyphosis (SK) or juvenile kyphosis, and mainly affects the thoracic or thoracolumbar
The body mass index (BMI) was 18.9 ± 2.9 for congenital kyphosis (CK) patients, 24.0 ± 2.7 for SK patients, and 21.7 ± 2.4 for tuberculotic kyphosis (TK) patients, and no group was significantly different from the controls (P = 0.378, 0.251, and 0.313, respectively)
Summary
A previous study reported a high prevalence of spinal epidural lipomatosis (SEL) in patients with Scheuermann kyphosis (SK) and suggested that it may play a role in the pathogenesis of this disease. The aim of this study was to test the hypothesis that SEL commonly occurs in patients with different types of kyphotic deformities as a secondary intraspinal disorder. The coexistence of spinal deformity and intraspinal anomalies has been reported in many previous studies [1,2,3,4]. The most obvious and frequently reported anomalies include syringomyelia, Chiari malformation, diastematomyelia, and tethered cord. Apart from these comparatively severe anomalies, which. Abul-Kasim et al [6] reported an intriguing finding that epidural lipomatosis is a common comorbidity of Scheuermann disease, which is known as Scheuermann kyphosis (SK) or juvenile kyphosis, and mainly affects the thoracic or thoracolumbar
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