The use of an autogenous free fat graft in the epidural space has been employed in an attempt to reduce post-op epidural scar formation. Opinion varies widely as to the effectiveness, some feel it is helpful, others feel it actually exacerbates scarring 1). In some patients, no evidence of the graft will be found on reoperation years later. The fat graft can very rarely be a cause of nerve root compression 2) or cauda equina syndrome 3) within the first few days post-op, and there is a case report of compression 6 years following surgery 4)