# Complete radiologic and clinical reversal of lumbar spinal epidural lipomatosis via GLP-1 agonist

## TL;DR

A man with severe spinal fat buildup and obesity achieved full recovery through weight loss using a GLP-1 drug and cannabis, avoiding surgery.

## Contribution

First documented case of spinal epidural lipomatosis reversal via non-surgical medical weight loss using a GLP-1 agonist.

## Key findings

- Patient lost 60 kg over one year using semaglutide and cannabis, leading to significant pain and mobility improvement.
- MRI showed near-complete regression of epidural fat and resolution of spinal stenosis.
- The patient avoided surgery and remained neurologically intact throughout the treatment.

## Abstract

Spinal epidural lipomatosis (SEL) is a rare cause of lumbar canal stenosis, typically linked to obesity or corticosteroid use. Severe cases often require decompression. We report a 48-year-old man with chronic low back pain and morbid obesity (153 kg) who presented with extensive SEL and critical stenosis. Previous conservative therapies failed. A non-surgical strategy using GLP-1–induced weight loss (semaglutide) and medical cannabis for pain control was initiated. Over a follow-up of one year, his weight dropped to 93.8 kg, with major improvement in pain and mobility. MRI demonstrated near-complete regression of epidural fat and resolution of stenosis, avoiding surgery. The patient remained neurologically intact. This appears to be the first documented case of SEL reversal achieved through medical weight loss alone. The findings highlight GLP-1 agonists as a potential therapeutic option in obesity-related spinal disorders and support cannabis as part of non-opioid pain management.