Significant symptom resolution of spinal lipomatosis with weight loss.

71-year-old male with epidural spinal lipomatosis and spondylolisthesis. Conservative treatment failed, and a spinal fusion and laminectomy were performed. Postoperatively, the patient reported a reduction in pain; however, the pain recurred soon after surgery. After losing 53 pounds with medical management, the patient reported a complete absence of pain. Epidural spinal lipomatosis is a rare condition characterized by the deposition and hypertrophy of adipose tissue in the spinal canal, sometimes resulting in stenosis or compression of the dural sac and nerve roots (Glob Spine J. 2018;9:658). Although several factors are considered to precipitate the disease, steroid use (J Am Acad Dermatol. 2017;76:1) and obesity (Neurosurg Focus. 2004;16:1) are considered among the most prevalent, with obesity controversially being listed under "idiopathic" causes occasionally (Glob Spine J. 2018;9:658). Weight reduction and decreased steroid use are first-line treatments for this disorder, and usually surgery is considered only when conservative treatment is ineffective (Glob Spine J. 2018;9:658). To describe a case of treating spinal lipomatosis within an evidence-based multidisciplinary medical weight management clinic.