A Case of Lumbosacral Arachnoiditis Ossificans

Abstract

The patient was a 13-year-old boy who complained of pain in both buttocks. Plain and reconstructive computed tomography (CT) images showed an ossified lesion within the dura mater at the L5–S2 levels, and arachnoiditis ossificans in the lumbosacral area was suspected. In the operative findings obtained after cutting the dura, a bone fragment 4.5 × 0.5 × 0.5 cm in size was observed in the center of the strongly adhesive nerve bundle of the cauda equina, which was removed en bloc. The postoperative clinical course of the patient was excellent. The case, along with a review of literature is presented.

Spinal arachnoid web—a distinct entity of focal arachnopathy with favorable long-term outcome after surgical resection: analysis of a multicenter patient population

“…Diagnostic modalities such as conventional MRI and computed tomography (CT) show an intradural, extramedullary calcified lesion compressing the spinal cord 31,32 . Similar to SAW, a history of prior spinal procedures is frequently reported in patients with this pathology [33][34][35] .…”

Immunotherapies in chronic adhesive arachnoiditis - A case series and literature review

“…Different causes for CSAA have been described, although it is important to note that the time between cause and manifestation varies greatly, with reports of up to 50 years [ 18 ]; therefore, only assumptions can be made. Furthermore, sporadic cases with no remarkable history explaining CSAA have been reported (3.6%) [ 4 , 19 , 20 ]. Historically, infections [ 5 , 18 , [21] , [22] , [23] , [24] ], mostly tuberculous meningitis [ 5 , [25] , [26] , [27] , [28] , [29] ], or myelographies due to the application of an oil-based contrast agent [ 2 , [30] , [31] , [32] , [33] , [34] , [35] ] played a major role as the cause of CSAA.…”

“…Chronic spinal adhesive arachnoiditis (CSAA) is characterized by inflammation and subsequent adhesion of the arachnoid layer, which may lead to progressive myelopathy [ 1 ]. It is usually caused by spinal cord (SC) lesions such as subarachnoid hemorrhages or alterations of the natural anatomic structure of the spine such as from spinal surgery [ [2] , [3] , [4] , [5] , [6] ]. During the course of the disease, cysts and venous congestion may occur with subsequent edema [ [7] , [8] , [9] ], leading to central spinal or radicular symptoms [ 3 , 10 , 11 ].…”

Spinal Arachnoiditis Ossificans: A Case-Based Update

“…1 Benign meningeal ossifications are frequently seen with an incidence up to 76% in autopsy studies and regarded as secondary agerelated degenerative processes or as disturbed calcium metabolism. 2,3 These leptomeningeal calcifications are generally asymptomatic and have no clinical significance. 4 The differentiation of arachnoiditis ossificans from benign leptomeningeal ossifications was determined by Kaufmann and Dunsmore in 1971.…”

“…Only a few case reports describe the cervical spine as the site of occurrence. 3 The disease has shown to be associated with infective, traumatic, iatrogenic, or vascular events. 1,5 A history of intradural surgeries, myelographies, spinal anesthesia, or subarachnoid hemorrhages has been described in case reports.…”