A New Subform? Fast-Progressing, Severe Neurological Deterioration Caused by Spinal Epidural Lipomatosis

Autor:	Thiemo Florin Dinger, Maija Susanna Eerikäinen, Anna Michel, Oliver Gembruch, Marvin Darkwah Oppong, Mehdi Chihi, Tobias Blau, Anne-Kathrin Uerschels, Daniela Pierscianek, Cornelius Deuschl, Ramazan Jabbarli, Ulrich Sure, Karsten Henning Wrede
Jazyk:	angličtina
Rok vydání:	2022
Předmět:	spinal surgery acute paraparesis -- spinal cord injury -- spinal epidural lipomatosis -- spine -- pathophysiology -- neurological outcome -- spinal surgery -- atypical fat depositions atypical fat depositions Medizin General Medicine spine Article spinal cord injury spinal epidural lipomatosis acute paraparesis pathophysiology neurological outcome Medizinische Fakultät » Universitätsklinikum Essen » Institut für Diagnostische und Interventionelle Radiologie und Neuroradiologie Medicine Medizinische Fakultät » Universitätsklinikum Essen » Klinik für Neurochirurgie Wirbelsäulenchirurgie Medizinische Fakultät » Universitätsklinikum Essen » Institut für Neuropathologie ddc:610
Zdroj:	Journal of Clinical Medicine; Volume 11; Issue 2; Pages: 366 Journal of Clinical Medicine Journal of Clinical Medicine, Vol 11, Iss 366, p 366 (2022)
ISSN:	2077-0383
DOI:	10.3390/jcm11020366
Popis:	Spinal epidural lipomatosis (SEL) is a rare condition caused by hypertrophic growth of epidural fat. The prevalence of SEL in the Western world is approximately 1 in 40 patients and is likely to increase due to current medical and socio-economic developments. Rarely, SEL can lead to rapid severe neurological deterioration. The pathophysiology, optimal treatment, and outcome of these patients remain unclear. This study aims to widen current knowledge about this “SEL subform” and to improve its clinical management. A systematic literature review according to the PRISMA guidelines using PubMed, Scopus, Web of Science, and Cochrane Library was used to identify publications before 7 November 2021 reporting on acute/rapidly progressing, severe SEL. The final analysis comprised 12 patients with acute, severe SEL. The majority of the patients were male (9/12) and multimorbid (10/12). SEL mainly affected the thoracic part of the spinal cord (11/12), extending a median number of 7 spinal levels (range: 4–19). Surgery was the only chosen therapy (11/12), except for one critically ill patient. Regarding the outcome, half of the patients regained independence (6/11; = modified McCormick Scale ≤ II). Acute, severe SEL is a rare condition, mainly affecting multimorbid patients. The prognosis is poor in nearly 50% of the patients, even with maximum therapy. Further research is needed to stratify patients for conservative or surgical treatment.
Databáze:	OpenAIRE
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