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We present risk factors for SEL and clinical long-term outcome data after surgical treatment for patients with pure SEL and a mixed-type pathology with combined SEL and LSS (SEL+LSS) compared to patients with pure LSS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      From our prospective institutional database, we identified all consecutive patients who were surgically treated for newly diagnosed SEL (\n                      <jats:italic>n<\/jats:italic>\n                      = 31) and SEL+LSS (\n                      <jats:italic>n<\/jats:italic>\n                      = 26) between 2018 and 2022. In addition, a matched control group of patients with pure LSS (\n                      <jats:italic>n<\/jats:italic>\n                      = 30) was compared. Microsurgical treatment aimed for posterior decompression of the spinal canal. Study endpoints were outcome data including clinical symptoms at presentation, MR-morphological analysis, evaluation of pain-free walking distance, pain perception by VAS-N\/-R scales, and patient\u2019s satisfaction by determination of the Odom score.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients with osteoligamentous SEL were significantly more likely to suffer from obesity (body mass index (BMI) of 30.2 \u00b1 5.5 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.03), lumbar pain (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.006), and to have received long-term steroid therapy (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.01) compared to patients with SEL+LSS and LSS. In all three groups, posterior decompression of the spinal canal resulted in significant improvement of these symptoms. Patients with SEL had a significant increase in pain-free walking distance during the postoperative course, at discharge, and last follow-up (FU) (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.0001), similar to patients with SEL+LSS and pure LSS. In addition, patients with pure SEL and SEL+LSS had a significant reduction in pain perception, represented by smaller values of VAS-N and -R postoperatively and at FU, similar to patients with pure LSS. In uni- and multivariate analysis, domination of lumbar pain and steroid long-term therapy were significant characteristic risk factors for SEL.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Surgical treatment of pure SEL and SEL+LSS allows significant improvement in pain-free walking distance and pain perception immediately postoperatively and in long-term FU, similar to patients with pure LSS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00701-023-05814-0","type":"journal-article","created":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T21:01:46Z","timestamp":1695589306000},"page":"3479-3491","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Outcome of posterior decompression for spinal epidural lipomatosis"],"prefix":"10.1007","volume":"165","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1387-0630","authenticated-orcid":false,"given":"Michael","family":"Schmutzer-Sondergeld","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna","family":"Zimmermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raimund","family":"Trabold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Liebig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Schichor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Siller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,9,25]]},"reference":[{"key":"5814_CR1","doi-asserted-by":"publisher","unstructured":"Ahmad S, Best T, Lansdown A, Hayhurst C, Smeeton F, Davies S, Rees A (2020) Spinal epidural lipomatosis: a rare association of Cushing\u2019s disease. 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This study was approved by the institutional review board of the Ludwig-Maximilians-University in Munich (reference number 21-1084).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}]}}