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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

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

There is an increased risk of developing epidural lipomatosis with:

  • Chronic corticosteroid use.
  • Cushing syndrome.
  • Obesity.
  • 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.

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

  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.

THORACIC EPIDURAL LIPOMATOSIS: VIEW IMAGES

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