Spinal epidural lipomatosis is a rare diseases that can present with progressive neurological symptoms. It is most commonly observed in patients receiving long-term exogenous steroid therapy, but can also be seen in patients with endogenous steroid overproduction, obesity, or idiopathic origin. There is hypertrophy of the epidural adipose tissue, causing a narrowing of the spinal canal and compression of nerve root. The patients will present with progressive myelopathy and radicular symptoms are also common. Conservative treatment-weaning from steroids use or weight loss can reverse the hypertrophy of the adipose tissue and relieve the neural compression. If conservative management fails, removal of fat with decompressive laminectomy is also very successful at improving the patient's neurological symptoms.
