Spinal Adhesive Arachnoiditis: A Literature Review

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.