PREOPERATIVE DIAGNOSIS(ES):
Epidural lipomatosis with significant dural compression from L4-
S3.
POSTOPERATIVE DIAGNOSIS(ES):
Epidural lipomatosis with significant dural compression from L4-
S3.
PROCEDURE(S)/OPERATION(S) PERFORMED:
Bilateral laminectomy from L4-S3.
SUMMARY:
Under general anesthesia, the patient in prone position, the skin
was prepped in the usual fashion. Fluoroscopy was used initially
to confirm the exact location of the L5-S1 disk level. After
that, a midline skin incision was made in the lumbosacral area.
Dissection was carried down through subcutaneous tissue to the
thoracolumbar fascia. The fascia was incised in the midline.
The paraspinal muscles were stripped bilaterally. The laminae of
L4, L5, S1, S2, and S3 were nicely exposed. Self-retaining
retractors were then applied. After that, I proceeded with
bilateral laminectomy of the lamina of L5, laminae of S1 and S2 and the upper
part of the lamina of S3. Also moved upward and removed the
lower part of the lamina of L4. The spinal canal was
decompressed from L4 to S3. Significant amount of epidural fat
was found and was removed. The fat was under pressure. Once I
removed the ligamentum flavum, the epidural fat started to herniate, and was removed, the spinal canal was nicely decompressed. The bleeding points were controlled. Gelfoam was then laid along the
dura. The site was profusely irrigated with bacitracin solution. The skin was then closed in layers. The patient tolerated the procedure well and was transferred to recovery room in
satisfactory condition.
Epidural lipomatosis with significant dural compression from L4-
S3.
POSTOPERATIVE DIAGNOSIS(ES):
Epidural lipomatosis with significant dural compression from L4-
S3.
PROCEDURE(S)/OPERATION(S) PERFORMED:
Bilateral laminectomy from L4-S3.
SUMMARY:
Under general anesthesia, the patient in prone position, the skin
was prepped in the usual fashion. Fluoroscopy was used initially
to confirm the exact location of the L5-S1 disk level. After
that, a midline skin incision was made in the lumbosacral area.
Dissection was carried down through subcutaneous tissue to the
thoracolumbar fascia. The fascia was incised in the midline.
The paraspinal muscles were stripped bilaterally. The laminae of
L4, L5, S1, S2, and S3 were nicely exposed. Self-retaining
retractors were then applied. After that, I proceeded with
bilateral laminectomy of the lamina of L5, laminae of S1 and S2 and the upper
part of the lamina of S3. Also moved upward and removed the
lower part of the lamina of L4. The spinal canal was
decompressed from L4 to S3. Significant amount of epidural fat
was found and was removed. The fat was under pressure. Once I
removed the ligamentum flavum, the epidural fat started to herniate, and was removed, the spinal canal was nicely decompressed. The bleeding points were controlled. Gelfoam was then laid along the
dura. The site was profusely irrigated with bacitracin solution. The skin was then closed in layers. The patient tolerated the procedure well and was transferred to recovery room in
satisfactory condition.