| ORIGINAL ARTICLE |
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| Year : 2010 | Volume
: 1
| Issue : 2 | Page : 100-106 |
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Focal adhesive arachnoiditis of the spinal cord: Imaging diagnosis and surgical resolution
Hiroki Morisako, Toshihiro Takami, Toru Yamagata, Isao Chokyu, Naohiro Tsuyuguchi, Kenji Ohata
Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan
Correspondence Address:
Toshihiro Takami
Department of Neurosurgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585
Japan
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0974-8237.77673
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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. |
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