Objective:

To explore diagnosis and surgical treatment of symptomatic lumbar spinal epidural lipoplasia.

Methods:

A retrospective analysis of 19 patients with symptomatic lumbar spinal epidural hyperplasia treated with hemilaminectomy and interbody fusion and internal fixation from February 2012 to November 2018 were performed, including 7 males and 12 females, aged from 48 to 72 years old with an average of (57.6±1.2) years old;the course of disease ranged from 6 to 60 months with an average of (18.6±5.1) months;plane requiring decompression:L_{2, 3}-L₅S₁ on 4 cases, L_{2, 3}-L_{4, 5} on 5 cases, L_{3, 4}-L_{4, 5} on 2 cases, L_{3, 4}-L₅S₁ on 6 cases, L_{4, 5}-L₅S₁ on 2 cases. Visual analogue scale (VAS) before operation and 6 months after opertaionwere used to evaluate relief of leg pain and back pain, Oswestry Disability Index (ODI) was used to evaluate recovery of functiona, and Fischgrund was used to assess overall efficacy.

Results:

All patients were followed up from 12 to 37 months with an average of (16.3±3.8) months. Ninteen patients were successfully completed operation, and all adipose tissues in the compressed segment of the spinal canal were removed. Operation time was from 125 to 260 min with an average of (186± 15) min, and blood bleeding was from 150 to 500 ml with an average of (280±46) ml. Two patients occurred partial incision fat liquefaction and exudate did not heal, the incision was opened to remove effusion, the dressing was changed and anti-inflammatory treatments were performed. No complications such as cauda equina injury, cerebrospinal fluid leakage, and broken nails occurred. Preopertaive VAS of back pain and leg pain were 5.3±0.7 and 6.8±0.8, respectively, while 2.1±0.4 and 2.3±0.5 respectively at 6 months after opertaion, there were statisticalsignificant difference between 6 months after operation and before operation (P<0.05). Postoperative ODI score at 6 months was 12.1±2.3, and significantly improved than that of before operation 45.5±2.8 (P<0.05). According to Fischgrund criteria, 13 patients got excellent result, 4 good, and 2 fair.

Conclusion:

Patients with symptomatic lumbar spinal epidural lipoplasia undergo hemilaminectomy and internal fixation of compression segment could relieve compression of dura mater and cauda equina, and achieve good clinical results.