Arachnoiditis


Arachnoiditis Definition:


Arachnoiditis is a pain disorder caused by the inflammation of the arachnoid, one of the membranes that surround and protect the nerves of the spinal cord. It is characterized by severe stinging, "burning pain," and neurological problems.


Arachnoiditis Symptoms:


Arachnoiditis has no consistent pattern of symptoms, but in many people it affects the nerves connecting to the lower back and legs. The most common symptom is pain; but, arachnoiditis can also cause:

Tingling, numbness, or weakness in the legs
Sensations that may feel like insects crawling on the skin or water trickling down the leg
Severe shooting pain that can be similar to an electric shock sensation
Muscle cramps, spasms and uncontrollable twitching
Bladder, bowel and/or sexual dysfunction
Direct injury to the spine

Possible Causes:


Chemicals: Dye used in myelograms (diagnostic tests in which a dye called radiographic contrast media is injected into the area surrounding the spinal cord and nerves) have been blamed for some cases of arachnoiditis. This seems particularly true with the older oil-based chemicals used for myelograms. The particular radiographic contrast media responsible for this is no longer used, however. Also, there is concern that the preservatives found in epidural steroid injections may cause arachnoiditis.

Infection from bacteria or viruses: Infections such as viral and fungal meningitis or tuberculosis can affect the spine.

Chronic compression of spinal nerves: Causes for this compression include chronic degenerative disc disease or advanced spinal stenosis (narrowing of spinal column).

Complications from spinal surgery or other invasive spinal procedures: Similar causes include multiple lumbar (lower back) punctures.


Prognosis:


Inflammation of the arachnoid can lead to the formation of scar tissue and can cause the spinal nerves to stick together (adhesive arachnoiditis) and malfunction. The arachnoid can become inflamed because of an irritation from one of the following sources:

As the disease progresses, symptoms may become more severe or even permanent. Many people with arachnoiditis are unable to work and suffer significant disability because they are in constant pain. Causes of Arachnoiditis


Treatment option available in Germany.


Endoscopic operations were performed on patients suffering from varying symptoms with an enlarged lumbar subarachnoidal space. Having confirmed the diagnosis of lumbar arachnoiditis, a number of endoscopic operations ranging from adhesiolysis to subarachno-epidurostomy are carried out.


Results:


Radicular symptoms in lumbar arachnoiditis were successfully relieved by various endoscopic dissection techniques, such as restoration of the improved CSF flow by subarachno-epidurostomy along the rootlet. This has been identified as one of the causal factors of the clinical symptoms. In cases where lumbar pain persists in spite of a previous thecaloscopy, further treatment with a lumboperitoneal shunt device has proved most successful.