ARACHNOIDITIS

What is it?

Arachnoiditis is an inflammation of the arachnoid lining of the thecal sac and the Cauda Equina nerve roots, producing severe, incapacitating pain and neurological disability.

It can affect various places in the body, such as in the head, at the junction between the head and neck and all over the spine (cranial, servico-medullary, thoracic, lumbosacral).

Who gets it?

It has been associated with the following:

Myelography

• Oil-based contrast media.
• Increased volume of contrast injected.
• Hyperosmolarity of aqueous contrast.
• Difficulty in performance of myelography.
• Non-removal of Oily media
• Oil/Hyperosmolar myelography prior to surgery. Repeat Oil or Aqueous Hyperosmolar myelography.
• Blood in CSF at time of Iophendylate myelography.
• Interval: Laminectomy Epidural injections
• Short time between myelography

Surgery

• Presence of spinal stenosis.
• Difficult discectomy.
• Dural/arachnoid tears
• Intradural surgery
• Fibrillay cotton residues from patties/swabs.

What tests will the Doctor want to do?

The Doctor may want to undertake XRays and a CT scan of the spine and a myelogram.

A myelogram may show blunting of nerve root sleeves blocked nerve roots without cord displacement (2/3) streaking and clumping of contrast.

A CT scan may demonstrate fusion and clumping of nerve roots empty-appearing sac with roots adherent to wall .

What is the treatment?

There is no known cure. Treatment is symptomatic.

Arachnoiditis leads to chronic disability, long term drug/alcohol dependence and suicidal tendencies. The average life span is shortened by 12 years.