PMC6167793_01
CT bone window image of L4-5 which does not clearly demonstrate evidence of spinal epidural lipomatosis
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Fig1
The patient presented with computed tomography; revealing suspected left foraminal disc protrusion at L4-5 and bilateral L4-5 and L5-S1 facet hypertrophy, but no bony spinal stenosis (Fig. 1).
case 1, visualization of the "Y" sign indicating grade III compression
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Fig2
Inspection of the patient's T1 weighted MRI revealed the grade III pathognomonic "Y" sign (Fig. 2).
case 1, measurement of the "Y" sign using the modified method. "A" demonstrates the dural sac as measured with the modified method, "B" demonstrates the spinal canal, and EF is the difference between these measurements
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Fig3
A measurement of the patient's epidural fat using the modified method (a method used when a straight anterior to posterior measurement is not possible) developed by Borre et al. revealed the following: dural sac / epidural fat value of 0.19 and epidural fat / spinal canal value of 83.9% as measured by the authors (Fig. 3).
PMC6167793_02
case 2, epidural fat measurement pre LESI, demonstrating a grade 0, or normal finding. "A" demonstrates the spinal canal, "B" demonstrates the dural sac, and EF is the difference between these measurements. The L4-5 disc herniation is not visualized on this image
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Fig4
Radiographs demonstrated minimal spondylosis at the L4 and L5 vertebral bodies and a MRI demonstrated a mild posterior central disc herniation at L5-S1, but no evidence of SEL (Figs. 4 & 5).
case 2, pre LESI imagine without measurements. The L4-5 disc herniation is not visualized on this image
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Fig5
Radiographs demonstrated minimal spondylosis at the L4 and L5 vertebral bodies and a MRI demonstrated a mild posterior central disc herniation at L5-S1, but no evidence of SEL (Figs. 4 & 5).
case 2, post LESI imagine without measurements
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Fig6
When measured by the authors using the method developed by Borre et al., the dural sac diameter/epidural fat diameter was 1.07, and the epidural fat/spinal canal diameter was 48.3%, categorizing the patient as a grade I (borderline grade II) (Figs. 6 & 7).
case 2, epidural fat measurement post LESI, demonstrating a grade I (borderline grade II) SEL. "A" demonstrates the spinal canal, "C" and "D" demonstrates the EF on either side of the dural sac, and the dural sac is the difference between A and C + D
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Fig7
When measured by the authors using the method developed by Borre et al., the dural sac diameter/epidural fat diameter was 1.07, and the epidural fat/spinal canal diameter was 48.3%, categorizing the patient as a grade I (borderline grade II) (Figs. 6 & 7).