An interesting case of primary spinal arachnoiditis

Area of Science:

• Neurology
• Neurosurgery
• Pathology

Background:

• Spinal arachnoiditis involves inflammation of meninges and subarachnoid space, often secondary to trauma or infection.
• Primary spinal arachnoiditis, without a known preceding event, is rarely documented.

Observation:

• A 35-year-old female presented with progressive lower limb weakness and cystic lumbar spinal canal distortion.
• Initial surgery revealed thickened arachnoid and a spinal cyst; subsequent development of a thoracic syrinx and worsening symptoms occurred.

Findings:

• A syrinx-arachnoid shunt insertion successfully resolved the syrinx.
• Post-operative imaging demonstrated syrinx resolution and significant improvement in lower limb strength and detrusor function.

Implications:

• This case highlights the potential for surgical intervention in managing complex spinal arachnoiditis and associated syringomyelia.
• Effective treatment strategies for spinal arachnoiditis remain challenging, often focusing on symptomatic relief.