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Cauda equina arachnoiditis. A correlative clinical and roentgenologic study.

A E Brodsky

    Spine
    |March 1, 1978
    PubMed
    Summary

    Most myelograms showing arachnoiditis are misinterpretations. Spinal stenosis or surgical complications, not adhesive arachnoiditis, often cause these radiographic findings in patients with back pain.

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    Area of Science:

    • Neurosurgery
    • Radiology
    • Spinal Imaging

    Background:

    • Arachnoiditis, inflammation of the arachnoid mater, is often diagnosed via myelography.
    • Previous studies suggest arachnoiditis can lead to severe neurological deficits.
    • This study investigates the accuracy of myelographic diagnoses of arachnoiditis.

    Observation:

    • 93 patients with myelograms indicating arachnoiditis were analyzed.
    • Most patients had prior lumbar disc surgery or Pantopaque myelography.
    • Radiographic findings were correlated with clinical and surgical data.

    Findings:

    • The majority of myelographic findings attributed to arachnoiditis were actually caused by spinal stenosis, extraarachnoid dye, or extradural scar.
    • Only one patient exhibited classic severe symptoms of adhesive arachnoiditis.
    • Myelographic changes suggestive of arachnoiditis frequently coexist with other spinal pathologies.

    Implications:

    • Myelographic findings interpreted as arachnoiditis do not necessarily preclude further surgical intervention for conditions like disc pathology or nerve root entrapment.
    • The diagnosis of adhesive arachnoiditis should be made cautiously, considering alternative explanations for myelographic abnormalities.
    • Accurate interpretation of myelograms is crucial for appropriate patient management and surgical decision-making in spinal disorders.

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