Adhesive arachnoiditis is a chronic, rare disease that develops slowly and its symptoms are very unpleasant. What are the causes of sticky arachnoiditis and is it possible to treat it?
Adhesive arachnoiditis is a disease that is based on an inflammatory process in one of the three meninges - the arachnoid.
It causes damage to the nerve roots and, more rarely, to the spinal cord, which results in severe pain and disturbed sensation and movement of the limbs.
The name of the disease comes from one of the main complications of arachnoiditis, which includes the formation of adhesions in the subarachnoid space in the spinal canal of the spine.
There are 3 types of sticky arachnoiditis:
- localized
- segment
- spilled
Clumpy arachnoiditis - causes
Adhesive arachnoiditis is a disease caused by external factors that lead to infection and the development of inflammation within it. It is often an iatrogenic complication, i.e. an adverse consequence of treatment for the patient.
In exceptional situations, arachnoiditis occurs after surgical procedures on the spinal cord, lumbar puncture (i.e. after collecting the cerebrospinal fluid (CSF) for laboratory tests), after direct mechanical injuries, and even after administration of medicinal substances, bleeding into the spinal canal.
Clumpy arachnoiditis can also be a complication of viral, bacterial, or tuberculous meningitis.
Clumpy arachnoiditis - symptoms
Adhesive arachnoiditis is a chronic disease that develops gradually. The symptoms reported by patients result from the presence of adhesions, i.e. abnormal bands of connective tissue in the subarachnoid space, which put pressure on the roots of the spinal nerves.
They run through the sensory and motor fibers of the nerves, hence in most patients there is a progressive decline in neurological functions,feeling and movement.
The most troublesome feeling for patients is the feeling of chronic, burning pain of varying intensity, most often located in the lumbar region of the spine and lower limbs.
They also often report tingling and numbness in the legs, muscle weakness, and uncontrolled muscle contractions.
With the passage of time and the progress of the disease, the symptoms worsen, leading to the development of flaccid or spastic paresis of the lower limbs, depending on the location of inflammation and connective tissue adhesions, and consequently disability.
Worth knowingCerebrospinal meninges, arachnoid and subarachnoid spaces
There are three meninges that surround the brain in the skull from the outside and the spinal cord in the canal of the spinal cord of the spine. These are (listing from the tire closest to the nerve tissue):
- soft tire
- spider tire (cobweb)
- dura mater (sclera)
The cerebrospinal meninges are connective tissue membranes whose main task is to protect the central nervous system and the spinal cord against mechanical injuries. They differ in thickness and the type of tissue they are made of.
Between the soft dura and the spinal cord, the brain, and the spider dura, i.e. in the subarachnoid space, there is a cerebrospinal fluid that acts as a shock absorber for the delicate nervous tissue inside hard bone structures.
It is from here, in the lumbar region of the spine, where the doctor takes the fluid for examination in the case of suspected meningitis.
Adhesive arachnoiditis - research
Various imaging methods are used to diagnose and rule out other diseases of the nervous system, of which the most accurate, non-invasive and painless method is magnetic resonance imaging (MRI).
MRI is performed on the doctor's request, usually of the lumbosacral spine. To create an image, a strong magnetic field is used, therefore, during the examination, patients must not wear any metal elements, such as jewelry or watches, or metal fragments inside the body (e.g. pacemakers).
After administering a specialized contrast agent, gadolinium, the patient is placed in a closed tunnel where the radiation is turned on. The patient maintains contact with medical staff at all times thanks to microphones.
Before the examination, the patient should be informed aboutunpleasant, loud noise made by the machine and suggest the use of noise-reducing headphones. The EMG test, i.e. electromyography, is used to assess the scale of nerve root damage and nerve function in the course of sticky arachnoiditis.
Adhesive arachnoiditis - differential diagnosis
Clumpy spinal meningitis should be differentiated from many disease processes that may take place within the spinal cord and the meninges.
These include spinal arachnoid cysts, as well as abscesses and tumors located within the spinal cord.
Adhesive arachnoiditis - treatment
So far, there is no targeted treatment for adhesive arachnoiditis, doctors mainly focus on relieving pain. The most common therapy is conservative treatment, painkillers and rehabilitation treatments.
To alleviate the symptoms, a specialist neurosurgeon may decide to use invasive treatment, which consists in endoscopic release of the nerve roots pressed by adhesions.
It has been proven, however, that even such therapy does not bring long-term effects.
