Figure 422

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MRI of the lumbosacral spine. (A) Sagittal T1WI showing the dural sac severely compressed and narrowed from L4 downward. Note that it is pushed away from the spino-laminar line and the vertebral bodies by an abundant high-intensity fatty tissue. (B) On the axial cut the compressed dural sac (low-intensity signal) is of Y-shaped form.

tion. Not infrequently epidural lipomatosis is discovered as an incidental finding on imaging studies and does not merit special attention. In symptomatic patients elimination of risk factors such as exogenous steroids may bring some relief. Weight loss may lead to epidural fat reduction and clinical improvement in obese patients. When progressive neurological deficits are encountered or in patients with cauda equina syndrome surgical intervention is required. Laminectomy combined with fat debulking may bring about pain relief.


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