Idiopathic lumbosacral spinal epidural lipomatosis

 A 45-year-old obese man, previously healthy, presented with a 7-month history of neurogenic claudication of both legs and bilateral sciatic radiculopathy without bowel or bladder disturbances. He had a body mass index of 34.6 Kg/m² but neurological examination was normal. Spinal magnetic resonance imaging (MRI) showed an extensive lumbosacral spinal epidural lipomatosis (SEL) rounding and compressing the thecal sac and nerve roots (A-C). There was no other obvious etiology. After 5 months of follow-up, symptoms resolved by weight loss.