{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T12:34:31Z","timestamp":1773232471845,"version":"3.50.1"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"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) involves the aberrant growth of normal adipose tissue in the spinal canal. It lacks of distinctive clinical manifestations. However, it can infrequently present as incomplete cauda equina syndrome (CES), a condition necessitating urgent surgical intervention. We present a case of SEL primarily manifesting as acute incomplete CES. The patient underwent unilateral biportal endoscopic (UBE) spinal canal decompression and adipose tissue excision. This procedure led to satisfactory postoperative neurological improvement. This case underscores the efficacy of unilateral biportal endoscopy as a viable minimally invasive surgical approach for SEL when accompanied by incomplete CES.<\/jats:p>","DOI":"10.3389\/fsurg.2026.1762865","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T15:58:46Z","timestamp":1773158326000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Spinal epidural lipomatosis with incomplete cauda equina syndrome treated with unilateral biportal endoscopic technique"],"prefix":"10.3389","volume":"13","author":[{"given":"Zaiyin","family":"Deng","sequence":"first","affiliation":[{"name":"Division of Spine, Department of Orthopedics, Tongji Hospital affiliated to Tongji University, School of Medicine, Tongji University","place":["Shanghai, China"]},{"name":"Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration, Ministry of Education of the People's Republic of China, Tongji University","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yujin","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Spine, Department of Orthopedics, Tongji Hospital affiliated to Tongji University, School of Medicine, Tongji University","place":["Shanghai, China"]},{"name":"Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration, Ministry of Education of the People's Republic of China, Tongji University","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed Saud","family":"Shaik","sequence":"additional","affiliation":[{"name":"Division of Spine, Department of Orthopedics, Tongji Hospital affiliated to Tongji University, School of Medicine, Tongji University","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Duanyang","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Spine, Department of Orthopedics, Tongji Hospital affiliated to Tongji University, School of Medicine, Tongji University","place":["Shanghai, China"]},{"name":"Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration, Ministry of Education of the People's Republic of China, Tongji University","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rongjing","family":"Di","sequence":"additional","affiliation":[{"name":"Division of Spine, Department of Orthopedics, Tongji Hospital affiliated to Tongji University, School of Medicine, Tongji University","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhourui","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Spine, Department of Orthopedics, Tongji Hospital affiliated to Tongji University, School of Medicine, Tongji University","place":["Shanghai, China"]},{"name":"Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration, Ministry of Education of the People's Republic of China, Tongji University","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Ma","sequence":"additional","affiliation":[{"name":"Division of Spine, Department of Orthopedics, Tongji Hospital affiliated to Tongji University, School of Medicine, Tongji University","place":["Shanghai, China"]},{"name":"Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration, Ministry of Education of the People's Republic of China, Tongji University","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","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":"Global Spine J"},{"key":"B2","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":"B3","doi-asserted-by":"publisher","first-page":"25571","DOI":"10.52965\/001c.25571","article-title":"Spinal epidural lipomatosis: a comprehensive review","volume":"13","author":"Walker","year":"2021","journal-title":"Orthop Rev (Pavia)"},{"key":"B4","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1080\/0268869021000032887","article-title":"Cauda equina syndrome: what is the relationship between timing of surgery and outcome?","volume":"16","author":"Gleave","year":"2002","journal-title":"Br J Neurosurg"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1537","DOI":"10.1007\/s43465-025-01406-5","article-title":"MRI findings of extradural fat in patients with cauda equina syndrome: a novel perspective","volume":"59","author":"Luo","year":"2025","journal-title":"Indian J Orthop"},{"key":"B6","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1016\/j.spinee.2017.07.177","article-title":"Obesity and spinal epidural lipomatosis in cauda equina syndrome","volume":"18","author":"Cushnie","year":"2018","journal-title":"Spine J"},{"key":"B7","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1097\/BSD.0000000000001344","article-title":"Etiologies and outcomes of spinal epidural lipomatosis: systematic review of the literature and meta-analysis of reported cases","volume":"35","author":"Alomari","year":"2022","journal-title":"Clin Spine Surg"},{"key":"B8","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1016\/0895-6111(94)90007-8","article-title":"Lumbar epidural lipomatosis: the \u201cY\u201d sign of thecal sac compression","volume":"18","author":"Kuhn","year":"1994","journal-title":"Comput Med Imaging Graph"},{"key":"B9","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":"B10","doi-asserted-by":"publisher","first-page":"109937","DOI":"10.1016\/j.ejrad.2021.109937","article-title":"WHO Classification of soft tissue tumours 2020: an update and simplified approach for radiologists","volume":"143","author":"Bansal","year":"2021","journal-title":"Eur J Radiol"},{"key":"B11","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":"B12","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1186\/s13018-019-1298-3","article-title":"Comparison of bilateral decompression via unilateral laminotomy and conventional laminectomy for single-level degenerative lumbar spinal stenosis regarding low back pain, functional outcome, and quality of life - a randomized controlled, prospective trial","volume":"14","author":"Ko","year":"2019","journal-title":"J Orthop Surg Res"},{"key":"B13","doi-asserted-by":"publisher","first-page":"418","DOI":"10.31616\/asj.2021.0527","article-title":"Comparison of unilateral biportal endoscopy decompression and microscopic decompression effectiveness in lumbar spinal stenosis treatment: a systematic review and meta-analysis","volume":"17","author":"Junjie","year":"2023","journal-title":"Asian Spine J"},{"key":"B14","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1186\/s13018-025-06071-w","article-title":"Research advances in unilateral endoscopic spinal surgery for the treatment of lumbar disc herniation: a review","volume":"20","author":"Fang","year":"2025","journal-title":"J Orthop Surg Res"},{"key":"B15","doi-asserted-by":"publisher","first-page":"812","DOI":"10.14245\/ns.2550648.324","article-title":"Real-Time water pressure monitoring in unilateral biportal endoscopic spine surgery","volume":"22","author":"Yu","year":"2025","journal-title":"Neurospine"},{"key":"B16","doi-asserted-by":"publisher","first-page":"123386","DOI":"10.1016\/j.wneu.2024.10.115","article-title":"Clinical efficacy and complications of spinal surgery unilateral biportal endoscopy for cervical spondylosis: a systematic review and meta-analysis","volume":"194","author":"Li","year":"2025","journal-title":"World Neurosurg"},{"key":"B17","doi-asserted-by":"publisher","first-page":"S21","DOI":"10.14444\/8161","article-title":"Difficulties, challenges, and the learning curve of avoiding complications in lumbar endoscopic spine surgery","volume":"15","author":"Lewandrowski","year":"2021","journal-title":"Int J Spine Surg"},{"key":"B18","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.wneu.2019.05.214","article-title":"A novel percutaneous biportal endoscopic technique for symptomatic spinal epidural lipomatosis: technical note and case presentations","volume":"129","author":"Kang","year":"2019","journal-title":"World Neurosurg"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1309202","DOI":"10.3389\/fsurg.2024.1309202","article-title":"Case report: technical description and clinical evaluation of three cases of unilateral biportal endoscopic decompression for symptomatic spinal epidural lipomatosis","volume":"11","author":"Liu","year":"2024","journal-title":"Front Surg"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1580499","DOI":"10.3389\/fsurg.2025.1580499","article-title":"Unilateral biportal endoscopy for the treatment of symptomatic spinal epidural lipomatosis: a case report and literature review","volume":"12","author":"Li","year":"2025","journal-title":"Front Surg"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1366357","DOI":"10.3389\/fneur.2024.1366357","article-title":"Unilateral biportal endoscopy vs. open decompression for lumbar epidural lipomatosis-cohort study using a prospective registry","volume":"15","author":"Tan","year":"2024","journal-title":"Front Neurol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"973","DOI":"10.1186\/s12891-025-09231-5","article-title":"Short-term clinical efficacy of unilateral biportal endoscopic unilateral laminectomy for bilateral decompression for lumbar epidural lipomatosis: an observational study","volume":"26","author":"Gao","year":"2025","journal-title":"BMC Musculoskelet Disord"},{"key":"B23","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1016\/j.wneu.2019.02.051","article-title":"Spinal epidural lipomatosis: weight loss cure","volume":"125","author":"Trungu","year":"2019","journal-title":"World Neurosurg"},{"key":"B24","doi-asserted-by":"publisher","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":"B25","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1016\/S2213-8587(21)00179-0","article-title":"Effects of liraglutide on visceral and ectopic fat in adults with overweight and obesity at high cardiovascular risk: a randomised, double-blind, placebo-controlled, clinical trial","volume":"9","author":"Neeland","year":"2021","journal-title":"Lancet Diabetes Endocrinol"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1762865\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T15:58:48Z","timestamp":1773158328000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1762865\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,10]]},"references-count":25,"alternative-id":["10.3389\/fsurg.2026.1762865"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2026.1762865","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,10]]},"article-number":"1762865"}}