{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:42:13Z","timestamp":1761824533837,"version":"3.41.2"},"reference-count":11,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T00:00:00Z","timestamp":1744329600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p>Spinal epidural lipomatosis (SEL) is a rare condition characterized by excessive growth of adipose tissue in the epidural space, leading to spinal cord or nerve root compression. We present a case of a 37-year-old obese male who developed fluctuating paraplegia secondary to SEL. The patient initially presented with ascending weakness, which rapidly progressed to paraplegia, accompanied by sensory deficits and urinary incontinence. MRI revealed SEL with associated spinal cord compression. Although initially planned for decompressive surgery, the patient showed partial recovery, delaying the procedure. After laminectomy and excision of the lipomatosis, the patient demonstrated significant motor improvement, although mild sensory deficits persisted. Histopathological analysis confirmed the presence of adipocytes. This case highlights the importance of recognizing SEL, especially in patients with fluctuating neurological symptoms. Treatment strategies include weight management and surgical decompression, with a favorable prognosis for those undergoing timely intervention. Early diagnosis through MRI and appropriate management is key to improving outcomes.<\/jats:p>","DOI":"10.3389\/fsurg.2025.1533158","type":"journal-article","created":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T05:15:18Z","timestamp":1744348518000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Fluctuating paraplegia secondary to spinal epidural lipomatosis: a case report"],"prefix":"10.3389","volume":"12","author":[{"given":"Malak","family":"El Ayssami","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"Adem","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Attieh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mounir","family":"Khoury","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1709","DOI":"10.1007\/s00330-002-1716-4","article-title":"Lumbosacral epidural lipomatosis: MRI grading","volume":"13","author":"Borr\u00e9","year":"2003","journal-title":"Eur Radiol"},{"key":"B2","doi-asserted-by":"publisher","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":"B3","doi-asserted-by":"publisher","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":"B4","doi-asserted-by":"publisher","first-page":"322","DOI":"10.3390\/diagnostics13020322","article-title":"Could spinal epidural lipomatosis be the hallmark of metabolic syndrome on the spine? 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Case induced by exogenous contribution of ACTH","volume":"13","author":"Porras-Estrada","year":"2002","journal-title":"Neurocirugia (Astur)"},{"key":"B7","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1038\/sj.sc.3102099","article-title":"Idiopathic spinal epidural lipomatosis without obesity: a case with relapsing and remitting course","volume":"46","author":"Akhaddar","year":"2008","journal-title":"Spinal Cord"},{"key":"B8","doi-asserted-by":"publisher","first-page":"150","DOI":"10.4103\/1817-1745.76117","article-title":"Spinal epidural lipomatosis: an unusual cause of relapsing and remitting paraparesis","volume":"5","author":"Rajput","year":"2010","journal-title":"J Pediatr Neurosci"},{"key":"B9","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1007\/s11547-023-01741-3","article-title":"A new comprehensive MRI classification and grading system for lumbosacral central and lateral stenosis: clinical application and comparison with previous systems","volume":"129","author":"Spinnato","year":"2023","journal-title":"Radiol Med"},{"key":"B10","doi-asserted-by":"publisher","first-page":"969","DOI":"10.1016\/j.spinee.2017.02.010","article-title":"The prevalence of spinal epidural lipomatosis on magnetic resonance imaging","volume":"17","author":"Theyskens","year":"2017","journal-title":"Spine J"},{"key":"B11","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1016\/j.diii.2022.01.001","article-title":"Underreporting of spinal epidural lipomatosis: a retrospective analysis of lumbosacral MRI examinations from different radiological settings","volume":"103","author":"Spinnato","year":"2022","journal-title":"Diagn Interv Imaging"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1533158\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T05:15:19Z","timestamp":1744348519000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1533158\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,11]]},"references-count":11,"alternative-id":["10.3389\/fsurg.2025.1533158"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2025.1533158","relation":{},"ISSN":["2296-875X"],"issn-type":[{"type":"electronic","value":"2296-875X"}],"subject":[],"published":{"date-parts":[[2025,4,11]]},"article-number":"1533158"}}