Subarachnoid-subarachnoid bypass for spinal adhesive arachnoiditis

J Neurosurg Spine. 2014 Nov;21(5):817-20. doi: 10.3171/2014.7.SPINE131082. Epub 2014 Aug 29.

Abstract

The authors report a case of adhesive arachnoiditis (AA) and arachnoid cyst successfully treated by subarachnoid to subarachnoid bypass (S-S bypass). Arachnoid cysts or syringes sometimes compress the spinal cord and cause compressive myelopathy that requires surgical treatment. However, surgical treatment for AA is challenging. A 57-year-old woman developed leg pain and gait disturbance. A dorsal arachnoid cyst compressed the spinal cord at T7-9, the spinal cord was swollen, and a small syrinx was present at T9-10. An S-S bypass was performed from T6-7 to T11-12. The patient's gait disturbance resolved immediately after surgery. Two years later, a small arachnoid cyst developed. However, there was no neurological deterioration. The myelopathy associated with thoracic spinal AA, subarachnoid cyst, and syrinx improved after S-S bypass.

Keywords: AA = adhesive arachnoiditis; JOA = Japanese Orthopaedic Association; S-S = subarachnoid to subarachnoid; adhesive arachnoiditis; arachnoid cyst; subarachnoid to subarachnoid bypass; syrinx.

Publication types

  • Case Reports

MeSH terms

  • Arachnoid Cysts / complications
  • Arachnoid Cysts / diagnosis
  • Arachnoid Cysts / surgery*
  • Arachnoiditis / complications
  • Arachnoiditis / congenital*
  • Arachnoiditis / diagnosis
  • Arachnoiditis / surgery
  • Contrast Media
  • Diagnosis, Differential
  • Female
  • Gait Disorders, Neurologic / diagnosis
  • Gait Disorders, Neurologic / etiology
  • Gait Disorders, Neurologic / surgery*
  • Humans
  • Laminectomy
  • Magnetic Resonance Imaging
  • Middle Aged
  • Spinal Cord Compression / diagnosis
  • Spinal Cord Compression / etiology
  • Spinal Cord Compression / surgery*

Substances

  • Contrast Media

Supplementary concepts

  • Familial spinal arachnoiditis