内镜治疗腰椎硬膜外脂肪增多症:1例报告和综述

Endoscopic treatment of lumbar epidural lipomatosis:A case report and review

脊柱硬膜外脂肪增多症(spinal epidural lipomatosis,SEL)是一种罕见的疾病,其特征是正常无包膜的脂肪组织在椎管内沉积。SEL最常见的发病部位是腰骶椎,可压迫及侵犯脊髓、马尾神经以及神经根。此病无特异性临床表现,当以肛周刺痛、烧灼感为主要表现时更容易被误诊或漏诊。既往对于SEL的手术治疗以后路开放椎板切除减压手术为主,近年来脊柱内镜技术的发展使微创治疗SEL成为可能。本文报道1例通过单侧双通道脊柱内镜技术治疗SEL的病例,并从SEL的发病特点、临床表现、治疗等方面对近期发表的SEL相关文献进行回顾总结。

Spinal epidural lipomatosis(SEL)is a rare disease characterized by the deposition of normal,unencapsulated adipose tissue in the spinal canal.The most common site of SEL is in the lumbosacral spine,which can compress and invade the spinal cord,cauda equina,and nerve roots.This disease has no specific clinical manifestations,and is more likely to be misdiagnosed or missed when the main manifestations are perianal tingling and burning sensation.In the past,the main surgical treatment for SEL was posterior open laminectomy and decompression.In recent years,the development of spinal endoscopy has made minimally invasive treatment of SEL possible.This paper reports a case of SEL treated by unilateral biportal endoscopy,and reviews the recent literature on SEL from the aspects of the pathogenesis,clinical manifestations,and treatment.