Spinal epidural lipomatosis: case reports, literature review and meta-analysis.

BACKGROUND CONTEXT Symptomatic spinal epidural lipomatosis (SEL), a rare cause of spinal cord compression, has most often been associated with exogenous steroid use. PURPOSE Identify four associations with SEL, correlate the associated groups with level of disease and compare treatment with outcome data in these groups. STUDY DESIGN/SETTING Case reports of three patients and analysis of 104 cases from the literature. PATIENT SAMPLE Three patients from the senior author's practice. OUTCOME MEASURES Not applicable. METHODS The authors report three new cases of SEL not associated with steroid use. They review all available English literature and present a table of all 104 reported cases. RESULTS The clinical course of three new patients is reported. CONCLUSIONS Associated conditions are exogenous steroid use, obesity, endogenous steroid excess, and some remain idiopathic. Although SEL is a rare condition, our review of the literature reveals many more reported cases than previously thought. With increased awareness of this condition and improved imaging techniques, further studies of this disease should be undertaken.