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Spinal Adhesive Arachnoiditis: A Literature Review.

Jadhe Maillard1, Sávio Batista2, Felipe Medeiros1

  • 1Faculty of Medicine, Estácio de Sá University, Rio de Janeiro, BRA.

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|February 15, 2023
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Summary

Adhesive arachnoiditis (AA) is a rare inflammatory disease causing nerve root adhesions and cerebrospinal fluid disruption. Early management is crucial, though current treatments offer limited satisfaction.

Keywords:
adhesive arachnoiditisanesthesiaarachnoiditisobstetric complicationobstetric epiduralpostoperativespinal arachnoiditis

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Area of Science:

  • Neurology
  • Inflammatory Diseases

Background:

  • Adhesive arachnoiditis (AA) is a rare, inflammatory, scar-forming condition.
  • It can cause incapacitating sequelae due to adhesions disrupting cerebrospinal fluid flow and nerve root encapsulation.
  • Symptom onset varies, often delaying etiological discovery.

Purpose of the Study:

  • To review the characteristics, diagnosis, and management of adhesive arachnoiditis.
  • To highlight the challenges in early etiological identification and treatment efficacy.

Main Methods:

  • Review of literature on adhesive arachnoiditis.
  • Analysis of diagnostic criteria, particularly magnetic resonance imaging (MRI) findings.
  • Discussion of current therapeutic approaches.

Main Results:

  • AA involves adhesions that disrupt CSF flow, leading to nerve root atrophy and varied clinical manifestations (neurologic, urinary, gastrointestinal, dermatologic).
  • MRI is the gold standard for diagnosis, showing specific findings like pseudocysts and nerve root clustering.
  • Despite diagnostic capabilities, clinical correlation is essential as imaging findings may not align with symptoms.

Conclusions:

  • Adhesive arachnoiditis presents with diverse symptoms and diagnostic challenges.
  • Current pharmacological and non-pharmacological treatments for AA lack complete efficacy.
  • Further research into effective management strategies is warranted.