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EPIDURAL SPACE INVADERS: SPINE MRI EPIDURAL LIPOMATOSIS PART 2

THORACIC EPIDURAL LIPOMATOSIS RADIOLOGY

Thoracic Epidural lipomatosis is not uncommon to see but has a different appearance to Lumbar Epidural Lipomatosis

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With thoracic epidural lipomatosis there is excess fat accumulated in the epidural space.

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There is an increased risk of developing epidural lipomatosis with:

  • Chronic corticosteroid use.
  • Cushing syndrome.
  • Obesity.
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  • Epidural lipomatosis in the thoracic spine has a different appearance to Lumbar Epidural Lipomatosis.
  • In the lumbar spine we look for a trefoil appearance of the thecal sac.
  • However, in the thoracic spine we look for Increased epidural fat.
  • The fat accumulation is posterior and lateral.
  • This results in the Cord being displaced anteriorly and thecal sac effaced.
  • There is no trefoil appearance like you see in the lumbar spine.

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Posterior epidural fat measuring >6mm in AP diameter is abnormal.

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  1. Epidural lipomatosis in the thoracic spine has a different appearance to Lumbar Epidural lipomatosis (See Here).

  1. Look for increased fat in the epidural space and cord displacement.

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THORACIC EPIDURAL LIPOMATOSIS: VIEW IMAGES

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