Spinal Arachnoiditis Ossificans: Report of Quadruple-Triggered Case

Scalia, Gianluca; Certo, Francesco; Maione, Massimiliano; Barbagallo, Giuseppe

doi:10.1016/j.wneu.2018.11.203

Cited by 10 publications

(11 citation statements)

References 15 publications

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“…4 The differentiation of arachnoiditis ossificans from benign leptomeningeal ossifications was determined by Kaufmann and Dunsmore in 1971. 5,6 Histologically, arachnoiditis ossificans is distinguished from benign leptomeningeal ossifications, which displays with calcium crystals, by the detection of bone formation. 5,6 Arachnoiditis ossificans is most frequently located in the thoracic spine (66%); this is explained by the highest concentration of arachnoid cells in these segments.…”

Section: Review Of the Literaturementioning

confidence: 99%

“…5,6 Histologically, arachnoiditis ossificans is distinguished from benign leptomeningeal ossifications, which displays with calcium crystals, by the detection of bone formation. 5,6 Arachnoiditis ossificans is most frequently located in the thoracic spine (66%); this is explained by the highest concentration of arachnoid cells in these segments. 4,5,7 The next common site is the lumbosacral region (24%).…”

Section: Review Of the Literaturementioning

confidence: 99%

“…3,4,7 Subsequently, an increase in osteoblastic proliferation and bony metaplasia occurs, leading to progressive ossification. 3,6,8 Systemic metabolic conditions, particularly alterations in calcium metabolism, like hyperparathyroidism, seem to predispose to the formation of arachnoiditis ossificans. 1,5 Arachnoiditis ossificans is affecting nerval structures (spinal cord, nerve roots) by inflammatory processes or direct mechanical impairment, leading subsequently to neurological deficits.…”

Section: Pathogenesismentioning

confidence: 99%

“…Moreover, the circulation of the cerebrospinal fluid may be affected by space occupying intradural osseous structures that can result in the formation of syringomyelia and arachnoid cysts. [1][2][3]6 Spinal vascular abnormalities, such as vascular malformations, have been found in patients presenting with arachnoiditis ossificans. It is hypothesized that recurred bleeding generates inflammatory processes.…”

Section: Pathogenesismentioning

confidence: 99%

“…Therefore, decompression of the spinal canal over the entire length of the ossification, for example via a laminectomy, is recommended as the treatment of choice. 5,6,10 Removing calcified plaques adhering the spinal cord or the nerve roots should be avoided. Particularly in type III arachnoiditis ossificans, an aggressive removal of adherent osseous plaques from neural tissue can cause significant deterioration of neurological deficits.…”

Section: Treatmentmentioning

confidence: 99%

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Spinal Arachnoiditis Ossificans: A Case-Based Update

et al. 2021

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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 intradural concentric bony structure with partly incorporated and partly adherent nerve roots. A partial removal of the intradural calcifications was performed. Postoperatively, the patient showed neurological improvement. The removed intradural calcifications were submitted for histological analysis and proved to be normal bone tissue, notably containing yellow bone marrow. To our knowledge, the presence of yellow bone marrow within bony cavities of arachnoiditis ossificans has not previously been reported.

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