{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T12:04:59Z","timestamp":1791893099287,"version":"4.3.4"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2020,6,22]],"date-time":"2020-06-22T00:00:00Z","timestamp":1592784000000},"content-version":"vor","delay-in-days":173,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Spinal epidural lipomatosis (SEL) is well known but uncommon complication of endoscopic spine surgery. Here, we present a case of SEL that progressed focally and rapidly after endoscopic spinal surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Presentation of case<\/jats:title>\n                    <jats:p>A 67-year-old man presented with back and Lt. leg radiating pain. MRI of the lumbar spine demonstrated severe foraminal stenosis at Lt. L4\/5\/S1. He underwent endoscopic posterior foraminotomy at Lt. L4\/5\/S1. After surgery, his leg pain disappeared. A month after surgery, the patient developed Lt. leg pain again. MR images showed focally progressed epidural fat posterior to the L5 body. After removal of lipomatosis via endoscopic posterior decompression at L3\/4\/5, his symptoms improved.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Mostly, the epidural fat accumulates insidiously, and distributes widely across several levels. And the increased accumulation of fat is predominantly posterior and posterolateral within the spinal canal. As in this case, focally progressed SEL anterior to the dural sac is rare. And focally progressed SEL can be misdiagnosed for disc herniation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>SEL should be recognized as a rare complication of endoscopic spine surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2020.06.083","type":"journal-article","created":{"date-parts":[[2020,6,24]],"date-time":"2020-06-24T11:47:31Z","timestamp":1592999251000},"page":"1-4","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":15,"title":["Rapid progression of spinal epidural lipomatosis after percutaneous endoscopic spine surgery mimicking disc herniation"],"prefix":"10.1097","volume":"73","author":[{"given":"Myung Soo","family":"Youn","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Ha","family":"Woo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong Ki","family":"Shin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-1-20260114","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1177\/2192568218793617","article-title":"Spinal epidural lipomatosis: a review of pathogenesis, characteristics, clinical presentation, and management","volume":"9","author":"Kim","year":"2019","journal-title":"Glob. Spine J"},{"key":"R2-1-20260114","doi-asserted-by":"crossref","first-page":"201","DOI":"10.5694\/j.1326-5377.1975.tb111328.x","article-title":"Spinal cord compression by extradural fat after renal transplantation","volume":"1","author":"Lee","year":"1975","journal-title":"Med. J. Aust"},{"key":"R3-1-20260114","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1016\/j.spinee.2004.05.252","article-title":"Spinal epidural lipomatosis: case reports, literature review and meta-analysis","volume":"5","author":"Fogel","year":"2005","journal-title":"Spine J"},{"key":"R4-1-20260114","doi-asserted-by":"crossref","first-page":"S408","DOI":"10.1007\/s00586-011-1855-x","article-title":"Rapid progression of spinal epidural lipomatosis","volume":"21","author":"Choi","year":"2012","journal-title":"Eur. Spine J"},{"key":"R5-1-20260114","doi-asserted-by":"crossref","first-page":"e226985","DOI":"10.1136\/bcr-2018-226985","article-title":"Spinal epidural lipomatosis following bilateral spinal decompression surgery","volume":"12","author":"Greenish","year":"2019","journal-title":"BMJ Case Rep"},{"key":"R6-1-20260114","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.ijsu.2018.10.028","article-title":"The SCARE 2018 statement: updating consensus Surgical CAse REport (SCARE) guidelines","volume":"60","author":"Agha","year":"2018","journal-title":"Int. J. Surg"},{"key":"R7-1-20260114","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1097\/00007632-199706010-00021","article-title":"Posterior lumbar epidural fat as a functional structure? Histologic specificities","volume":"22","author":"Beaujeux","year":"1997","journal-title":"Spine"},{"key":"R8-1-20260114","first-page":"7","article-title":"Clinical implications of epidural fat in the spinal canal. A scanning electron microscopic study","volume":"60","author":"Reina","year":"2009","journal-title":"Acta Anaesthesiol. Belg"},{"key":"R9-1-20260114","first-page":"337","article-title":"Idiopathic lumbar epidural lipomatosis mimicking disc herniation: a case report","volume":"54","author":"Duran","year":"2016","journal-title":"Acta Med. Iran"},{"key":"R10-1-20260114","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1002\/aja.1001040303","article-title":"Fat in the epidural space in young and adult cats","volume":"104","author":"RAMSEY","year":"1959","journal-title":"Am. J. Anat"},{"key":"R11-1-20260114","first-page":"664","article-title":"Symptomatic deposition of epidural fat in a morbidly obese woman","volume":"3","author":"Badami","year":"1982","journal-title":"AJNR Am. J. Neuroradiol"},{"key":"R12-1-20260114","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1007\/BF00593392","article-title":"Reversibility of lumbar epidural lipomatosis in obese patients after weight-reduction diet","volume":"37","author":"Borstlap","year":"1995","journal-title":"Neuroradiology"},{"key":"R13-1-20260114","doi-asserted-by":"crossref","first-page":"348","DOI":"10.3171\/jns.1996.85.2.0348","article-title":"Symptomatic epidural lipomatosis secondary to obesity. Case report","volume":"85","author":"Kumar","year":"1996","journal-title":"J. Neurosurg"},{"key":"R14-1-20260114","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1186\/1471-2253-14-70","article-title":"Multiple epidural steroid injections and body mass index linked with occurrence of epidural lipomatosis: a case series","volume":"14","author":"Jaimes","year":"2014","journal-title":"BMC Anesthesiol"},{"key":"R15-1-20260114","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1146\/annurev.physiol.65.092101.142622","article-title":"The physiology of cellular liporegulation","volume":"65","author":"Unger","year":"2003","journal-title":"Annu. Rev. Physiol"},{"key":"R16-1-20260114","doi-asserted-by":"crossref","first-page":"1262","DOI":"10.1016\/j.jocn.2013.09.027","article-title":"Lumbosacral epidural lipomatosis causing rapid onset cauda equina syndrome","volume":"21","author":"Wells","year":"2014","journal-title":"J. Clin. Neurosci"},{"key":"R17-1-20260114","doi-asserted-by":"crossref","first-page":"1437","DOI":"10.1007\/s00590-018-2206-y","article-title":"Benefits of bariatric surgery on spinal epidural lipomatosis: case report and literature review","volume":"28","author":"Valcarenghi","year":"2018","journal-title":"Eur. J. Orthop. Surg. Traumatol"},{"key":"R18-1-20260114","doi-asserted-by":"crossref","first-page":"e33","DOI":"10.1016\/j.wneu.2019.01.098","article-title":"Symptomatic idiopathic spinal epidural lipomatosis in 9 patients: clinical, radiologic, and pathogenetic features","volume":"126","author":"Kellett","year":"2019","journal-title":"World Neurosurg"},{"key":"R19-1-20260114","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1097\/00006123-199707000-00015","article-title":"Idiopathic spinal epidural lipomatosis","volume":"41","author":"Robertson","year":"1997","journal-title":"Neurosurgery"},{"key":"R20-1-20260114","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1007\/978-3-642-81265-1_29","article-title":"Inhibition of glucose transport in fat cells and activation of lipolysis by glucocorticoids","volume":"12","author":"Fain","year":"1979","journal-title":"Monogr. Endocrinol"},{"key":"R21-1-20260114","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1111\/cen.13820","article-title":"The cortisol stress response induced by surgery: a systematic review and meta-analysis","volume":"89","author":"Prete","year":"2018","journal-title":"Clin. Endocrinol. (Oxf"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261220304867?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261220304867?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2020.06.083","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T13:22:21Z","timestamp":1768396941000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2020.06.083"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":21,"journal-issue":{"issue":"C","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2020.06.083","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2020,1]]}}}