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Date 2018-08-28
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Focal adhesive arachnoiditis of the spinal cord: Imaging diagnosis and surgical resolution

5/7/2014 Focal adhesive arachnoiditis of the spinal cord: Imaging diagnosis and surgical resolution

J Craniovertebr Junction Spine. 2010 Jul-Dec; 1(2): 100–106. PMCID: PMC3075825 doi: 10.4103/0974-8237.77673

 

Hiroki Morisako, Toshihiro Takami, Toru Yamagata, Isao Chokyu, Naohiro Tsuyuguchi, and Kenji Ohata

Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan
Corresponding author: Dr. Toshihiro Takami, Department of Neurosurgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi- machi, Abeno-ku, Osaka 545-8585, Japan E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Copyright : © Journal of Craniovertebral Junction and Spine
This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, w hich

permits unrestricted use, distribution, and reproduction in any medium, provided the original w ork is properly cited.

Abstract

Background:

Although adhesive arachnoiditis of the spinal cord can cause progressive symptoms associated with syringomyelia or myelomalacia, its surgical resolution based on the imaging diagnosis is not well characterized. This study aims to describe the use of imaging for the diagnosis of focal adhesive arachnoiditis of the spinal cord and its surgical resolution using microsurgical arachnoidolysis.

Materials and Methods:

Four consecutive patients with symptomatic syringomyelia or myelomalacia caused by focal adhesive arachnoiditis underwent microsurgical arachnoidolysis. Comprehensive imaging evaluation using constructive interference in steady-state (CISS) magnetic resonance imaging (MRI) or myelographic MR imaging using true fast imaging with steady-state precession (TrueFISP) sequences was included before surgery to determine the surgical indication.

Results:

In all four patients a focal adhesion was identified at the cervical or thoracic level of the spinal cord, a consequence of infection or trauma. Three patients showed modest or minor improvement in neurological function, and one patient was unchanged after surgery. The syringomyelia or myelomalacia resolved after surgery and no recurrence was noted within the follow-up period, which ranged from 5 months to 30 months.

Conclusions:

MRI diagnosis of focal adhesive arachnoiditis is critical to determine the surgical indication. Microsurgical arachnoidolysis appears to be a straightforward method for stabilizing the progressive symptoms, though the procedure is technically demanding.

Keywords: Arachnoiditis, arachnoidolysis, dural plasty, cerebrospinal fluid, syringomyelia

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Date 2018-08-28
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Gastroparesis - This stomach condition is suffered by a lot of us with spinal injuries

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Date 2018-08-15
Language  English
File Size 313.92 KB
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