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Spinal Epidural Lipomatosis: A Common Imaging Feature in Scheuermann Disease.

Abul-Kasim, Kasim LU ; Schlenzka, Dietrich; Selariu, Eufrozina LU and Ohlin, Acke LU (2012) In Journal of spinal disorders & techniques 25(7). p.356-361
Abstract
STUDY DESIGN:



Retrospective study.

OBJECTIVES:



To find out if spinal epidural lipomatosis (SEL) occurs more commonly among patients with Scheuermann disease than in the general population. SUMMARY AND

BACKGROUND:



On the basis of our own radiologic and operative observation, SEL seems to occur frequently in patients with Scheuermann disease.

METHODS:



Magnetic resonance imaging of 87 individuals (72% male, average age 19±6 y) from 2 centers (29 consecutive patients with Scheuermann disease and 58 controls) were retrospectively evaluated by 2 neuroradiologists. Spinal epidural fat (EF) at seventh thoracic vertebra (EF7), maximum EF (EFmax),... (More)
STUDY DESIGN:



Retrospective study.

OBJECTIVES:



To find out if spinal epidural lipomatosis (SEL) occurs more commonly among patients with Scheuermann disease than in the general population. SUMMARY AND

BACKGROUND:



On the basis of our own radiologic and operative observation, SEL seems to occur frequently in patients with Scheuermann disease.

METHODS:



Magnetic resonance imaging of 87 individuals (72% male, average age 19±6 y) from 2 centers (29 consecutive patients with Scheuermann disease and 58 controls) were retrospectively evaluated by 2 neuroradiologists. Spinal epidural fat (EF) at seventh thoracic vertebra (EF7), maximum EF (EFmax), dural sac diameter at T7 and at the level of maximum EF (DS7 and DSmax) were measured. EF ratios at T7 (EFR7) and at maximum EF (EFRmax) were calculated as EF/DS. Body mass index (BMI) for study population and kyphosis severity for the patients were recorded. Mann-Whitney, Spearman correlation, and χ tests were performed dependent on the variable in question.

RESULTS:



EF7, DS7, EFmax, EFR7, and EFRmax was significantly higher among patients with Scheuermann disease (EFmax 5.7±2.4 mm) than among controls (EFmax 3.8±1.1 mm), P<0.001. Twelve patients with Scheuermann disease (41%) fulfilled our proposed criteria for the diagnosis of SEL (EFmax>6 mm+EFRmax>0.51) compared with 2 (3%) among controls (P<0.001). Patients with Scheuermann disease exhibited higher BMI than controls (24.9±5 kg/m vs. 22.9±4 kg/m, P=0.138). Logistic regression showed that the occurrence of SEL among patients with Scheuermann disease was independent of BMI (P=0.880). The degree of kyphosis in patients with Scheuermann's disease (62±20°) was correlated to the amount of the EF.

CONCLUSIONS:



As SEL occurs more frequently among patients with Scheuermann disease, spine magnetic resonance imaging should be routinely performed to screen each of these patients to avoid impending neurological injury during surgery, especially in those exhibiting SEL. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
spinal epidural lipomatosis, scheuermann disease, epidural fat ratio, body mass index, pathogenesis, MRI
in
Journal of spinal disorders & techniques
volume
25
issue
7
pages
356 - 361
publisher
Lippincott Williams & Wilkins
external identifiers
  • wos:000311402000007
  • pmid:21705916
  • scopus:84866920158
ISSN
1539-2465
DOI
10.1097/BSD.0b013e31822631d3
language
English
LU publication?
yes
id
c402a081-bfe2-4bff-8496-ba3728ab5917 (old id 2007738)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21705916?dopt=Abstract
date added to LUP
2011-07-06 11:01:35
date last changed
2017-03-26 04:03:56
@article{c402a081-bfe2-4bff-8496-ba3728ab5917,
  abstract     = {STUDY DESIGN:<br/><br>
<br/><br>
Retrospective study.<br/><br>
OBJECTIVES:<br/><br>
<br/><br>
To find out if spinal epidural lipomatosis (SEL) occurs more commonly among patients with Scheuermann disease than in the general population. SUMMARY AND<br/><br>
BACKGROUND:<br/><br>
<br/><br>
On the basis of our own radiologic and operative observation, SEL seems to occur frequently in patients with Scheuermann disease.<br/><br>
METHODS:<br/><br>
<br/><br>
Magnetic resonance imaging of 87 individuals (72% male, average age 19±6 y) from 2 centers (29 consecutive patients with Scheuermann disease and 58 controls) were retrospectively evaluated by 2 neuroradiologists. Spinal epidural fat (EF) at seventh thoracic vertebra (EF7), maximum EF (EFmax), dural sac diameter at T7 and at the level of maximum EF (DS7 and DSmax) were measured. EF ratios at T7 (EFR7) and at maximum EF (EFRmax) were calculated as EF/DS. Body mass index (BMI) for study population and kyphosis severity for the patients were recorded. Mann-Whitney, Spearman correlation, and χ tests were performed dependent on the variable in question.<br/><br>
RESULTS:<br/><br>
<br/><br>
EF7, DS7, EFmax, EFR7, and EFRmax was significantly higher among patients with Scheuermann disease (EFmax 5.7±2.4 mm) than among controls (EFmax 3.8±1.1 mm), P&lt;0.001. Twelve patients with Scheuermann disease (41%) fulfilled our proposed criteria for the diagnosis of SEL (EFmax&gt;6 mm+EFRmax&gt;0.51) compared with 2 (3%) among controls (P&lt;0.001). Patients with Scheuermann disease exhibited higher BMI than controls (24.9±5 kg/m vs. 22.9±4 kg/m, P=0.138). Logistic regression showed that the occurrence of SEL among patients with Scheuermann disease was independent of BMI (P=0.880). The degree of kyphosis in patients with Scheuermann's disease (62±20°) was correlated to the amount of the EF.<br/><br>
CONCLUSIONS:<br/><br>
<br/><br>
As SEL occurs more frequently among patients with Scheuermann disease, spine magnetic resonance imaging should be routinely performed to screen each of these patients to avoid impending neurological injury during surgery, especially in those exhibiting SEL.},
  author       = {Abul-Kasim, Kasim and Schlenzka, Dietrich and Selariu, Eufrozina and Ohlin, Acke},
  issn         = {1539-2465},
  keyword      = {spinal epidural lipomatosis,scheuermann disease,epidural fat ratio,body mass index,pathogenesis,MRI},
  language     = {eng},
  number       = {7},
  pages        = {356--361},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Journal of spinal disorders & techniques},
  title        = {Spinal Epidural Lipomatosis: A Common Imaging Feature in Scheuermann Disease.},
  url          = {http://dx.doi.org/10.1097/BSD.0b013e31822631d3},
  volume       = {25},
  year         = {2012},
}