The results of surgical treatment of lumbar arachnoiditis

Abstract

S u m m a r y . Forty patients with lumbar arachnoiditis, following previous operations, were classified into 4 myelographic types. Most patients with type I images had herniated disc symptoms with unilateral leg pain and limited straight-leg raising. Patients with types H and III myelographic appearances had bilateral leg pain, absent ankle jerks, weakness, cramps and signs of diffuse sensory deficit; some also had neurogenic claudication and urinary sphincter dysfunction. All patients with type IV had dysaesthesia. Twenty-three of the 40 patients underwent reoperation and those with types I and H had acceptable results, but poor results occurred in those with types III and IV myelograms. R6sum6. Quarante patients atteints d'arachno'idite lombaire ont ~t~ class& selon les images mydlographiques en quatre groupes. La plupart des patients avec une image de type I prdsentent des signes de hernie discale avec sciatalgies unilatdrales et limitation de l'extension de la jambe. Chez les patients pr&entant des caractdristiques mydlographiques de type H et III prddominent des sciatalgies bilatdrales, des spasmes musculaires, de la faiblesse, des crampes et des troubles sensitifs diffus. Quelques patients prdsentent un syndrome neurologique ddficitaire et une atteinte sphinctdrienne. Tous les malades avec des images mydlographiques de type IV ont des dysesthdsies. Vingt-trois patients sur quarante ont dtd rdopdrds. L'intervention a obtenu un r~sultat satisfaisant (bon et moyen) chez les patients avec des images mydlographiques de type I e t II. Chez ceux qui avaient des mydlographies de type III et IV les mauvais r6sultats ont dtd beaucoup plus frdquents.

Revision surgery for lumbar disc herniation

“…Of the 3 patients with type III arachnoiditis (Roca et al [25]), one achieved an excellent result, and 2 had a good result following microsurgical removal of extruded disc material through a singlelevel laminectomy without fusion (Fig. 3 a, b).…”

Compression of the S1 Nerve Root by an Extradural Vascular Malformation: A Case Report and Discussion of Atypical Causes of Lumbar Radiculopathy

“…MRI is reportedly 99% accurate, and a staging system has been described by Ross et al 39 Most patients present with lumbar radiculopathy, though sensory deficits, back pain, decreased bowel and bladder function, and motor deficits have all been described. [39][40][41] Spinal cord arteriovenous malformations (AVM) may exist as arteriovenous fistulas (AVF), first described as ''hemorrhoids of the pia mater,'' and differ from intradural or intraparenchymal vascular malformations. 12,42,41 Currently, AVMs are classified as type I, dural AVF, type II, glomus or intramedullary AVMs, type III, juvenile large intramedullary, extramedullary, and extradural AVMs often over several spinal levels and type IV, intradural extramedullary AVFs arising from the anterior spinal artery or posterior spinal artery as opposed to type I AVFs, which arise from dural branches.…”

Aracnoiditis crónica

“…después del procedimiento. 29 Estos medios se descontinuaron en los años 90 para dar paso a los provistos con base de agua, dentro de las cuales están la metrizamida y el iohexol. El cua dro clínico se manifiesta por dolor lumbar crónico, debilidad de miembros inferiores, incapacidad para la bipedestación autónoma, urgencia miccional y de deposición.…”