Figure - available from: The Surgery Journal
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Photomicrograph of the intradural specimen showing yellow bone marrow within the intradural bone (arrowhead).
Source publication
Arachnoiditis ossificans is a rare disease, characterized by intradural ossifications, representing the end stage of chronic adhesive arachnoiditis. We describe the case of a 55-year-old patient who developed symptoms of a cauda equina syndrome after an open microdiscectomy at the L5 to S1 segment. A subsequent exploratory surgery revealed an intra...
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BACKGROUND
Spinal adhesive arachnoid pathology is a rare cause of myelopathy. Because of rarity and variability, mechanisms of myelopathy are unknown. The authors retrospectively analyzed patients to understand pathophysiology and provide implications for surgical treatment.
OBSERVATIONS
Nineteen consecutive patients were studied. Thirteen patient...
Citations
... Он характеризуется постоянными ноющими болями в грудном и поясничном отделах позвоночника и/или в ногах, усиливающимися при физической нагрузке и проходящими в покое. Также у части пациентов наблюдались жалобы на гипестезии, парестезии и нарушение походки [2,[8][9][10]27]. В некоторых случаях отмечалось нарушение функции тазовых органов, преимущественно мочевого пузыря, в виде недержания [2-4, 7, 10, 11, 27]. ...
Objective. To present a clinical case of arachnoiditis ossificans associated with syringomyelia and a brief literature review with an emphasis on its etiology, pathogenesis and methods of diagnosis and treatment.
Material and Methods. A clinical case of a 68-year-old patient with symptomatic arachnoiditis ossificans is described. The diagnosis was established on the basis of the results of intraoperative biopsy, histological examination of the resected fragment and confirmed in the postoperative period using CT of the spinal cord, multislice CT myelography, etc. Analysis of the course of the pathology raised the following questions: diagnostic criteria and optimal tactics for treating this disease. A brief review of cases of arachnoiditis ossificans described in the literature for the period from 1982 to the present is given.
Results. A review of cases of ossifying arachnoiditis described in the literature showed that today there is no single tactic for diagnosing and treating this disease. In most cases, the diagnosis is established intraoperatively (65 % of analyzed cases). At the preoperative stage, CT provides reliable visualization of ossification. When choosing therapy, it is necessary to be based on the severity of the clinical picture, the degree of ossification of the arachnoid membrane and the presence of concomitant pathology of the affected spinal cord department (such as syringomyelia).
Conclusion. The presence of a growing neurological deficit should be considered an indication for surgical treatment of patients with arachnoiditis ossificans. The goals of surgery should include decompression of neural structures and restoration of normal cerebrospinal fluid circulation.
... CT data of the patient showed signs of dural calcification.His MRI data showed that the cauda equina had adhesions with the dorsal arachnoid membrane. They believe that arachnoiditis is responsible for cauda equina syndrome and curvilinear dural calcification [17]. In 2021, Brunner A et al [18] introduced a case of intradural calcification caused by chronic adhesive arachnoiditis and performed a dural incision exploration, and found nerve calcification structures in the dural sac. ...
Background:
Post-traumatic cauda equina nerve calcification is extremely rare in clinical practice, and its etiology, pathogenesis, treatment and prognosis are unclear. There are few studies and reports on Post-traumatic cauda equina nerve calcification, and this review reports a case of Post-traumatic cauda equina nerve calcification for reference.
Case summary:
A 52-year-old patient presented to our hospital with a history of lumbar spinal stenosis and a lumbar vertebral fracture caused by trauma. The patient's right lower limb had weakness in hip flexion, knee extension and plantarflexion with muscle strength grade 3, right ankle dorsiflexion and thumb dorsiflexion with muscle strength grade 0. The patient's skin sensation below the right knee plane disappeared. The patient's Computed tomography (CT) data showed signs of cauda equina nerve calcification and the terminal filaments in the plane of the third to fifth lumbar vertebrae. After treatment the patient's symptoms were slightly relieved.
Conclusion:
We provide an extremely rare case of Post-traumatic cauda equina nerve calcification and offer a conservative treatment plan. However, the etiology, mechanism and treatment of Post-traumatic cauda equina nerve calcification are still unclear. This requires scholars to conduct more research and exploration in this area.
Arachnoiditis ossificans is a rare pathologic entity defined by calcification or ossification of the spinal arachnoid layer. The lesion is typically limited to the spinal thoracic regions (2/3 of cases) and less frequently in the lumbar spine (1/4 of cases).
