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Arachnoiditis

Arachnoiditis describes a pain disorder caused by the inflammation of the arachnoid, one of the membranes that surround and protect the nerves of the spinal cord. The arachnoid can become inflamed because of an irritation from chemicals, infection from bacteria or viruses, as the result of direct injury to the spine, chronic compression of spinal nerves, or complications from spinal surgery or other invasive spinal procedures. Inflammation can sometimes lead to the formation of scar tissue and adhesions, which cause the spinal nerves to "stick" together. more...

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If arachnoiditis begins to interfere with the function of one or more of these nerves, it can cause a number of symptoms, including numbness, tingling, and a characteristic stinging and burning pain in the lower back or legs. Arachnoiditis has no consistent pattern of symptoms, but it more frequently affects the nerves that supply the lower back and legs.

Prognathisism

Arachnoiditis is a chronic pain disorder and while there is no known cure at this time some quality of life may be redeemed through pain management routines. Prognosis is often complicated by the lack of a clear relationship between time of onset and pattern of symptoms. Aging and pre-existing spinal disorders can make accurate prognosis problematic. For many, arachnoiditis is a disabling disease that causes chronic pain and neurological deficits.

Treatment

Arachnoiditis remains a difficult condition to treat, and long-term outcomes are unpredictable. Most treatments for arachnoiditis are focused on pain relief and the improvement of symptoms that impair daily function. A regimen of pain management, physiotherapy, exercise, and psychotherapy is often recommended. Surgical intervention is controversial since the outcomes are generally poor and provide only short-term relief. Clinical trials of steroid injections and electrical stimulation are needed to determine the efficacy of these treatments.

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Altered compliance and fluid flow in a model of post-traumatic syringomyelia
From Journal of Bone and Joint Surgery, 1/1/03 by Brodbelt, A R

INTRODUCTION: It has been suggested that arachnoiditis predisposes to post-traumatic syringomyelia formation by obstructing subarachnoid cerebrospinal fluid flow and enhancing perivascular flow into the cord. In an animal model of post-traumatic syringomyelia (PTS), fluid flow in spinal cord perivascular spaces (PVS) is greater at the level of arachnoiditis and syrinx than at other levels and fluid enters the syrinx via the PVS. This study was performed to determine the effects of cerebrospinal fluid (CSF) diversion from the subarachnoid space on perivascular flow and syrinx formation in PTS.

METHODS: Twenty six male Sprague-Dawley rats were investigated using the CSF tracer horseradish peroxidase (HRP). the excitotoxic and arachnoiditis model of PTS, and lumboperitoneal shunt insertion. Four experimental groups consisted of syrinx only and shunt only controls, and shunt insertion before or after syrinx formation. CSF flow studies were performed six weeks following the final intervention. Grading scales were used to quantify HRP staining.

RESULTS: Syrinxes formed in all animals. Perivascular flow was greatest at the level of the syrinx. Cerebral cortex perivascular flow was significantly reduced following shunt insertion in animals with a syrinx (p

DISCUSSION: Increasing distal subarachnoid space compliance does not affect local CSF flow into the spinal cord and syrinx. These results suggest that localised alterations in compliance, as opposed to obstruction from traumatic arachnoiditis, act as an important factor in syrinx pathogenesis.

A.R. Brodbelt, M.A. Stoodley, A. Watling, J. Tu, *N. Jones

Prince of Wales Medical Research Institute, University of New South Wales, Sydney, Australia; * Department of Surgery (Neurosurgery) University of Adelaide, Adelaide, Australia

Copyright British Editorial Society of Bone & Joint Surgery 2003
Provided by ProQuest Information and Learning Company. All rights Reserved

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