Arachnoiditis ossificans

Revilla, T. Yolanda; Ramos, A. Alvarez; González, Pedro Manuel Garamendi; Alday, Rafael Escudero; Millán, José María

doi:10.1016/s0899-7071(98)00085-0

Cited by 21 publications

(7 citation statements)

References 14 publications

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“…Collapse of the syrinx was noted with some postoperative clinical improvement in two of these reports 5,8. Clinical improvement was also noted by several authors who only performed decompression and removal of ossified plaque without myelotomy or shunting of the syrinx 7,9. This was also observed in the current study.…”

Section: Discussionsupporting

confidence: 89%

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Arachnoiditis ossificans associated with syringomyelia: An unusual cause of myelopathy

Ibrahim

Kamali-Nejad²,

Fehlings³

2010

Evidence-Based Spine-Care Journal

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Objective: The pathophysiology of arachnoiditis ossificans (AO) and its association with syringomyelia remains a rare and poorly understood phenomenon. Here, we present a case of AO associated with syringomyelia, a review of literature, and a discussion of current understanding of disease pathophysiology.Methods: A literature review was performed using MEDLINE (January 1900–May 2010) and Embase (January 1900–May 2010) to identify all English-language studies that described AO with syringomyelia. The current report was added to published cases.Results: Over 50 cases of AO are reported in literature, of which only eight are associated with syringomyelia. The various presumptive etiologies of syrinx formation include abnormalities in blood circulation, ischemia, hydrodynamic alternations in cerebrospinal fluid (CSF) flow, tissue damage, or incidental coexistence. Changing CSF dynamics related to decreased compliance of the subarachnoid space and subsequent paracentral dissection of the spinal cord may be implicated in the disease process. magnetic resonance imaging (MRI) scanning may identify the syrinx but fail to diagnose the calcified arachnoid. Five patients, including the current case, improved clinically following laminectomy and decompression.Conclusions: Syringomyelia in association in AO is a rare phenomenon. A high index of suspicion is required and both MRI and computed tomography (CT) are recommended for diagnosis. The pathophysiology of syringomyelia in AO remains an area of ongoing research.

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Section: Discussionsupporting

confidence: 89%

“…Over 50 reports of AO are documented in literature; however, only eight of these are associated with syringomyelia 2,3,4,5,6,7,8,9. The pathophysiology of syrinx development in this disease state is controversial.…”

Section: Introductionmentioning

confidence: 99%

Arachnoiditis ossificans associated with syringomyelia: An unusual cause of myelopathy

Ibrahim

Kamali-Nejad²,

Fehlings³

2010

Evidence-Based Spine-Care Journal

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“…Cases of AO are exceedingly rare and the full extent of these lesions should be documented utilizing CT.[ 5 ] MR, however, should also be performed to search for any associated syringomyelia. Good results have been achieved by treating AO with noncommunicating syringomyelia with laminectomy accompanied by decompression/excision of ossified tissue and shunt placement in the conus.…”

Section: Discussionmentioning

confidence: 99%

Arachnoiditis ossificans and syringomyelia: A unique presentation

Opalak¹,

Opalak²

2015

Surg Neurol Int

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Background:Arachnoiditis ossificans (AO) is a rare disorder that was differentiated from leptomeningeal calcification by Kaufman and Dunsmore in 1971. It generally presents with progressive lower extremity myelopathy. Though the underlying etiology has yet to be fully described, it has been associated with various predisposing factors including vascular malformations, previous intradural surgery, myelograms, and adhesive arachnoiditis. Associated conditions include syringomyelia and arachnoid cyst. The preferred diagnostic method is noncontrast computed tomography (CT). Surgical intervention is still controversial and can include decompression and duroplasty or durotomy.Case Description:The authors report the case of a 62-year-old male with a history of paraplegia who presented with a urinary tract infection and dysautonomia. His past surgical history was notable for a C4–C6 anterior fusion and an intrathecal phenol injection for spasticity. A magnetic resonance image (MR) also demonstrated a T6-conus syringx. At surgery, there was significant ossification of the arachnoid/dura, which was removed. After a drain was placed in the syrinx, there was a significant neurologic improvement.Conclusion:This case demonstrates a unique presentation of AO and highlights the need for CT imaging when a noncommunicating syringx is identified. In addition, surgical decompression can achieve good results when AO is associated with concurrent compressive lesions.

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“…По данным литературы, в отсроченном периоде после шунтирования состояние улучшается у 12-53% па-циентов, остается без изменений у 10-56% и продолжает ухудшаться у 12-32% [4,19]. При лечении пациентов с сирингомиелией и сопутствующей АО Domenicucci, T. Revilla [4,13] не проводили шунтирования кисты, но тем не менее состояние пациентов улучшилось, а киста уменьшилась в размерах. В нашей практике при проведении операций пациентам с арахнопатией III, IV степени мы используем оба метода: устраняем фиксацию, восстанавливаем ликвородинамику с последующим шунтированием кисты.…”

Section: рис 4 клинический пример №3 (интраоперационное фото)unclassified

“…Клинически значимая ОА встречается крайне редко. В настоящее время в мировой литературе описаны не более 80 подобных наблюдений и только 12 из них -с сопутствующей сирингомиелией [2,[4][5][6][7][8][9][10][11][12][13][14][15].…”

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