腰骶部硬膜外脊髓注射与腰骶部硬膜外脂肪增多症有关系吗？回顾性研究。

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie Pub Date : 2025-01-10 DOI:10.1016/j.neuchi.2025.101636

Ali A. Al-Omari , Naser Obeidat , Adham F. Alnemer , Ala’M. Abu Dalou

{"title":"腰骶部硬膜外脊髓注射与腰骶部硬膜外脂肪增多症有关系吗？回顾性研究。","authors":"Ali A. Al-Omari , Naser Obeidat , Adham F. Alnemer , Ala’M. Abu Dalou","doi":"10.1016/j.neuchi.2025.101636","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>We aim to investigate the potential association between the administration of Lumbosacral epidural steroid injections (LESIs) and the subsequent onset or progression of Lumbosacral epidural lipomatosis (LEL) in patients devoid of established risk factors for LEL.</div></div><div><h3>Methods</h3><div>We carried out a single-center retrospective study on patients who underwent LESI. We collected demographics including age and gender as well as clinical and radiological characteristics including the type of corticosteroids utilized, the number of LESIs administered, the use of epidural guidance during LESI procedures, and LEL grading. Any patient aged ≥18 years who underwent LESI was included. Exclusion criteria encompassed the absence of magnetic resonance imaging (MRI) data both prior to and following the intervention, presence of endocrinopathies such as Cushing's syndrome or hypothyroidism, diabetes mellitus, and hyperlipidemia.</div></div><div><h3>Results</h3><div>A total of 3,000 patients were initially screened, 268 patients met the inclusion criteria and were included in the analysis. Mean age was 53.63 years (±12.27), and 50% were male. The predominant treatment administered was methylprednisolone (96.4%). 86% of the patients underwent a single LESI. Fluoroscopy was the guiding modality in 250 (94%) patients. An analysis of LEL grades both before and after LESI revealed variations, with a 7.5% incidence of grade change observed. Logistic regression analysis indicated a trend between male gender and the occurrence of LEL.</div></div><div><h3>Conclusions</h3><div>Our study emphasizes the relationship between LESIs and the development of LEL and the progression of existing LEL. Further research should investigate this link by conducting larger controlled imaging studies.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 2","pages":"Article 101636"},"PeriodicalIF":1.5000,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Is there a relationship between lumbosacral epidural spinal injections and lumbosacral epidural lipomatosis? A retrospective study\",\"authors\":\"Ali A. Al-Omari , Naser Obeidat , Adham F. Alnemer , Ala’M. Abu Dalou\",\"doi\":\"10.1016/j.neuchi.2025.101636\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>We aim to investigate the potential association between the administration of Lumbosacral epidural steroid injections (LESIs) and the subsequent onset or progression of Lumbosacral epidural lipomatosis (LEL) in patients devoid of established risk factors for LEL.</div></div><div><h3>Methods</h3><div>We carried out a single-center retrospective study on patients who underwent LESI. We collected demographics including age and gender as well as clinical and radiological characteristics including the type of corticosteroids utilized, the number of LESIs administered, the use of epidural guidance during LESI procedures, and LEL grading. Any patient aged ≥18 years who underwent LESI was included. Exclusion criteria encompassed the absence of magnetic resonance imaging (MRI) data both prior to and following the intervention, presence of endocrinopathies such as Cushing's syndrome or hypothyroidism, diabetes mellitus, and hyperlipidemia.</div></div><div><h3>Results</h3><div>A total of 3,000 patients were initially screened, 268 patients met the inclusion criteria and were included in the analysis. Mean age was 53.63 years (±12.27), and 50% were male. The predominant treatment administered was methylprednisolone (96.4%). 86% of the patients underwent a single LESI. Fluoroscopy was the guiding modality in 250 (94%) patients. An analysis of LEL grades both before and after LESI revealed variations, with a 7.5% incidence of grade change observed. Logistic regression analysis indicated a trend between male gender and the occurrence of LEL.</div></div><div><h3>Conclusions</h3><div>Our study emphasizes the relationship between LESIs and the development of LEL and the progression of existing LEL. Further research should investigate this link by conducting larger controlled imaging studies.</div></div>\",\"PeriodicalId\":51141,\"journal\":{\"name\":\"Neurochirurgie\",\"volume\":\"71 2\",\"pages\":\"Article 101636\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-01-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neurochirurgie\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0028377025000098\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurochirurgie","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0028377025000098","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

摘要

背景：我们的目的是调查腰骶部硬膜外类固醇注射（LESIs）与腰骶部硬膜外脂肪沉积症（LEL）患者随后发病或进展之间的潜在关联，这些患者没有确定的LEL危险因素。方法：我们对行LESI的患者进行了单中心回顾性研究。我们收集了人口统计数据，包括年龄和性别，以及临床和放射学特征，包括使用的皮质类固醇类型，给予LESI的次数，LESI过程中硬膜外指导的使用，以及LEL分级。所有年龄≥18岁且接受LESI的患者均被纳入。排除标准包括干预前后没有磁共振成像（MRI）数据，存在内分泌疾病，如库欣综合征或甲状腺功能减退，糖尿病和高脂血症。结果：初步筛选出3000例患者，其中268例符合纳入标准，纳入分析。平均年龄53.63岁（±12.27岁），男性占50%。主要的治疗方法是甲基强的松龙（96.4%）。86%的患者进行了一次LESI。250例（94%）患者以透视检查为指导方式。对LESI前后LEL等级的分析显示了变化，观察到等级变化的发生率为7.5%。Logistic回归分析显示，男性与LEL的发生有一定的关系。结论：本研究强调LESIs与LEL的发展及现有LEL的进展之间的关系。进一步的研究应该通过进行更大规模的对照成像研究来调查这种联系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Is there a relationship between lumbosacral epidural spinal injections and lumbosacral epidural lipomatosis? A retrospective study

Background

We aim to investigate the potential association between the administration of Lumbosacral epidural steroid injections (LESIs) and the subsequent onset or progression of Lumbosacral epidural lipomatosis (LEL) in patients devoid of established risk factors for LEL.

Methods

We carried out a single-center retrospective study on patients who underwent LESI. We collected demographics including age and gender as well as clinical and radiological characteristics including the type of corticosteroids utilized, the number of LESIs administered, the use of epidural guidance during LESI procedures, and LEL grading. Any patient aged ≥18 years who underwent LESI was included. Exclusion criteria encompassed the absence of magnetic resonance imaging (MRI) data both prior to and following the intervention, presence of endocrinopathies such as Cushing's syndrome or hypothyroidism, diabetes mellitus, and hyperlipidemia.

Results

A total of 3,000 patients were initially screened, 268 patients met the inclusion criteria and were included in the analysis. Mean age was 53.63 years (±12.27), and 50% were male. The predominant treatment administered was methylprednisolone (96.4%). 86% of the patients underwent a single LESI. Fluoroscopy was the guiding modality in 250 (94%) patients. An analysis of LEL grades both before and after LESI revealed variations, with a 7.5% incidence of grade change observed. Logistic regression analysis indicated a trend between male gender and the occurrence of LEL.

Conclusions

Our study emphasizes the relationship between LESIs and the development of LEL and the progression of existing LEL. Further research should investigate this link by conducting larger controlled imaging studies.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Neurochirurgie 医学-临床神经学

CiteScore

2.70

自引率

6.20%

发文量

100

审稿时长

29 days

期刊介绍： Neurochirurgie publishes articles on treatment, teaching and research, neurosurgery training and the professional aspects of our discipline, and also the history and progress of neurosurgery. It focuses on pathologies of the head, spine and central and peripheral nervous systems and their vascularization. All aspects of the specialty are dealt with: trauma, tumor, degenerative disease, infection, vascular pathology, and radiosurgery, and pediatrics. Transversal studies are also welcome: neuroanatomy, neurophysiology, neurology, neuropediatrics, psychiatry, neuropsychology, physical medicine and neurologic rehabilitation, neuro-anesthesia, neurologic intensive care, neuroradiology, functional exploration, neuropathology, neuro-ophthalmology, otoneurology, maxillofacial surgery, neuro-endocrinology and spine surgery. Technical and methodological aspects are also taken onboard: diagnostic and therapeutic techniques, methods for assessing results, epidemiology, surgical, interventional and radiological techniques, simulations and pathophysiological hypotheses, and educational tools. The editorial board may refuse submissions that fail to meet the journal''s aims and scope; such studies will not be peer-reviewed, and the editor in chief will promptly inform the corresponding author, so as not to delay submission to a more suitable journal. With a view to attracting an international audience of both readers and writers, Neurochirurgie especially welcomes articles in English, and gives priority to original studies. Other kinds of article - reviews, case reports, technical notes and meta-analyses - are equally published. Every year, a special edition is dedicated to the topic selected by the French Society of Neurosurgery for its annual report.