Focal adhesive arachnoiditis of the spinal cord: Imaging diagnosis and surgical resolution
| Autor: | Naohiro Tsuyuguchi, Kenji Ohata, Hiroki Morisako, Isao Chokyu, Toshihiro Takami, Toru Yamagata |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2010 |
| Předmět: |
medicine.medical_specialty
lcsh:Diseases of the musculoskeletal system cerebrospinal fluid Cerebrospinal fluid dural plasty medicine Adhesive arachnoiditis Imaging diagnosis medicine.diagnostic_test business.industry Magnetic resonance imaging medicine.disease Spinal cord syringomyelia Surgery medicine.anatomical_structure Arachnoiditis Original Article Neurology (clinical) lcsh:RC925-935 arachnoidolysis business Myelomalacia Syringomyelia |
| Zdroj: | Journal of Craniovertebral Junction and Spine Journal of Craniovertebral Junction and Spine, Vol 1, Iss 2, Pp 100-106 (2010) |
| ISSN: | 0976-9285 0974-8237 |
| Popis: | Background: Although adhesive arachnoiditis of the spinal cord can cause progressive symptoms associated with syringomyelia or myelomalacia, its surgical resolution based on the imaging diagnosis is not well characterized. This study aims to describe the use of imaging for the diagnosis of focal adhesive arachnoiditis of the spinal cord and its surgical resolution using microsurgical arachnoidolysis. Materials and Methods: Four consecutive patients with symptomatic syringomyelia or myelomalacia caused by focal adhesive arachnoiditis underwent microsurgical arachnoidolysis. Comprehensive imaging evaluation using constructive interference in steady-state (CISS) magnetic resonance imaging (MRI) or myelographic MR imaging using true fast imaging with steady-state precession (TrueFISP) sequences was included before surgery to determine the surgical indication. Results: In all four patients a focal adhesion was identified at the cervical or thoracic level of the spinal cord, a consequence of infection or trauma. Three patients showed modest or minor improvement in neurological function, and one patient was unchanged after surgery. The syringomyelia or myelomalacia resolved after surgery and no recurrence was noted within the follow-up period, which ranged from 5 months to 30 months. Conclusions: MRI diagnosis of focal adhesive arachnoiditis is critical to determine the surgical indication. Microsurgical arachnoidolysis appears to be a straightforward method for stabilizing the progressive symptoms, though the procedure is technically demanding. |
| Databáze: | OpenAIRE |
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