The changing pattern of spinal arachnoiditis.

Abstract

SUMMARY Spinal arachnoiditis is a rare condition. Eighty cases, diagnosed during a period when 7600 spinal contrast investigations were undertaken, have been reviewed. The majority had suffered a previous spinal condition, the most common being lumbar disc disease. There has been a change in the distribution of arachnoiditis with the lumbar region now most frequently involved. This accounts for the persistence of radicular symptoms and the relatively low incidence of paraplegia when compared with earlier series. Surgery does not appear to have any role in the treatment.

Postlumbar puncture arachnoiditis mimicking epidural abscess

“…One example of iatrogenic trauma causing arachnoiditis is lumbar puncture. Although lumbar puncture, one of the spinal interventions, is generally considered safe, it may lead to complications such as arachnoiditis, various infectious diseases, radiculopathy and myelopathy 2 9. In contrast to the fact that arachnoiditis generally occurs as a result of the introduction of drugs or contrast materials into the subarachnoid space, arachnoiditis which occurs after diagnostic lumbar puncture without injection of any drug or substance into the subarachnoid space, as seen in our case, is very rare.…”

Postlumbar puncture arachnoiditis mimicking epidural abscess

“…One example of iatrogenic trauma causing arachnoiditis is lumbar puncture. Although lumbar puncture, one of the spinal interventions, is generally considered safe, it may lead to complications such as arachnoiditis, various infectious diseases, radiculopathy and myelopathy 2 9. In contrast to the fact that arachnoiditis generally occurs as a result of the introduction of drugs or contrast materials into the subarachnoid space, arachnoiditis which occurs after diagnostic lumbar puncture without injection of any drug or substance into the subarachnoid space, as seen in our case, is very rare.…”

Non-traumatic adhesive arachnoiditis as a cause of spinal cord syndromes. Investigation on 507 patients

“…Evidence of arachnoiditis without other abnormalities was found in 95 out of 105 patients. The most common findings (similar to those of Lombardi et al, 1962;Shaw et al, 1978) were adhesions (the finest of them could be seen ruptur ing when the table was tilted rapidly), filling defects, narrowing of one or more segments or sometimes complete obstruction of the subarachnoid space, fixity of previously inserted oil contrast medium, obliteration of the nerve root sleeves and pseudocyst formation. In 80 patients the changes were diffuse, usually pre dominant in the C7-T8 segments, but frequently extending up to the high cervical region and thereby reducing or preventing the flow of the contrast medium into the cisternal spaces in the supine myelogram.…”

Diagnosis and management of tuberculous paraplegia with special reference to tuberculous radiculomyelitis.

“…Syphilis, pyogenic, or fungal infection, carcinomatous meningitis, and a variety of noninfective agents may cause this syndrome, and a similar localised spinal arachnoiditis may occur rarely after myelography, or after other intrathecal infections, particularly in the presence of other spinal disorders. (Shaw et al, 1978). Nonetheless, Wadia and Dastur (1969) failed to find a cause in 10 of their 70 cases.…”

Postlumbar puncture arachnoiditis mimicking epidural abscess

“…One example of iatrogenic trauma causing arachnoiditis is lumbar puncture. Although lumbar puncture, one of the spinal interventions, is generally considered safe, it may lead to complications such as arachnoiditis, various infectious diseases, radiculopathy and myelopathy 2 9. In contrast to the fact that arachnoiditis generally occurs as a result of the introduction of drugs or contrast materials into the subarachnoid space, arachnoiditis which occurs after diagnostic lumbar puncture without injection of any drug or substance into the subarachnoid space, as seen in our case, is very rare.…”

Non-traumatic adhesive arachnoiditis as a cause of spinal cord syndromes. Investigation on 507 patients

“…Evidence of arachnoiditis without other abnormalities was found in 95 out of 105 patients. The most common findings (similar to those of Lombardi et al, 1962;Shaw et al, 1978) were adhesions (the finest of them could be seen ruptur ing when the table was tilted rapidly), filling defects, narrowing of one or more segments or sometimes complete obstruction of the subarachnoid space, fixity of previously inserted oil contrast medium, obliteration of the nerve root sleeves and pseudocyst formation. In 80 patients the changes were diffuse, usually pre dominant in the C7-T8 segments, but frequently extending up to the high cervical region and thereby reducing or preventing the flow of the contrast medium into the cisternal spaces in the supine myelogram.…”

Diagnosis and management of tuberculous paraplegia with special reference to tuberculous radiculomyelitis.

“…Syphilis, pyogenic, or fungal infection, carcinomatous meningitis, and a variety of noninfective agents may cause this syndrome, and a similar localised spinal arachnoiditis may occur rarely after myelography, or after other intrathecal infections, particularly in the presence of other spinal disorders. (Shaw et al, 1978). Nonetheless, Wadia and Dastur (1969) failed to find a cause in 10 of their 70 cases.…”

Postlumbar puncture arachnoiditis mimicking epidural abscess

“…One example of iatrogenic trauma causing arachnoiditis is lumbar puncture. Although lumbar puncture, one of the spinal interventions, is generally considered safe, it may lead to complications such as arachnoiditis, various infectious diseases, radiculopathy and myelopathy 2 9. In contrast to the fact that arachnoiditis generally occurs as a result of the introduction of drugs or contrast materials into the subarachnoid space, arachnoiditis which occurs after diagnostic lumbar puncture without injection of any drug or substance into the subarachnoid space, as seen in our case, is very rare.…”

Non-traumatic adhesive arachnoiditis as a cause of spinal cord syndromes. Investigation on 507 patients

“…Evidence of arachnoiditis without other abnormalities was found in 95 out of 105 patients. The most common findings (similar to those of Lombardi et al, 1962;Shaw et al, 1978) were adhesions (the finest of them could be seen ruptur ing when the table was tilted rapidly), filling defects, narrowing of one or more segments or sometimes complete obstruction of the subarachnoid space, fixity of previously inserted oil contrast medium, obliteration of the nerve root sleeves and pseudocyst formation. In 80 patients the changes were diffuse, usually pre dominant in the C7-T8 segments, but frequently extending up to the high cervical region and thereby reducing or preventing the flow of the contrast medium into the cisternal spaces in the supine myelogram.…”

Diagnosis and management of tuberculous paraplegia with special reference to tuberculous radiculomyelitis.

“…Syphilis, pyogenic, or fungal infection, carcinomatous meningitis, and a variety of noninfective agents may cause this syndrome, and a similar localised spinal arachnoiditis may occur rarely after myelography, or after other intrathecal infections, particularly in the presence of other spinal disorders. (Shaw et al, 1978). Nonetheless, Wadia and Dastur (1969) failed to find a cause in 10 of their 70 cases.…”