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T1 weighted and short T1 inversion recovery (STIR) sequence MRI imaging: white arrow points to the epidural lipomatosis.
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The MRI results demonstrated a pathological overgrowth of fat tissue in the spinal canal with a marked impingement of the dural sac, which showed severe central canal stenosis with space occupying epidural fat in the lumbar lesion (Fig. 1).
Partial laminectomy and removal of hypertrophic fat tissue performed during surgery.
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L2/3 and L3/4 decompression and fat removal with partial laminectomy (Fig. 2), and L4/5 and L5/S1 total laminectomy with posterolateral fusion with pedicle screw fixation were performed without delay.
Histopathology confirms benign adipose fat tissue under a microscope.
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Histopathological examination showed the presence of normal fat cells, in the absence of venous engorgement, hypervascularization, or bleeding (Fig. 3).