Case: Spinal epidural lipomatosis (SEL) is the epidural accumulation of adipose tissue, sometimes associated with steroid use. There are limited reported cases of pediatric SEL. The purpose of this case report was to describe a 15-year-old girl with severe sagittal malalignment secondary to steroid-induced SEL associated with cardiac transplant rejection immunotherapy. She underwent multilevel decompression without traditional deformity correction and fusion, which improved her spinal deformity and symptoms. She had improved sagittal alignment and clinical outcomes at 2-year follow-up. Conclusion: Nonstructural spinal deformities due to SEL can be improved with a limited decompression when nonoperative treatment fails.
Kress et al. (2026) studied this question.