he Arachnoiditis-Like Nerve Root Distribution in the Thecal Sac of the Degenerative Disc Diseases.
- Author:
Myun Whan AHN
;
Yong Yeun KIM
;
Woo Mok BYUN
- Publication Type:Original Article
- MeSH:
Adhesives;
Arachnoid;
Arachnoiditis;
Constriction;
Diagnosis;
Failed Back Surgery Syndrome;
Humans;
Magnetic Resonance Imaging;
Spinal Canal;
Spinal Stenosis;
Spondylolisthesis
- From:Journal of Korean Society of Spine Surgery
1997;4(2):300-308
- CountryRepublic of Korea
- Language:English
-
Abstract:
Since the introduction of MRI, the arachnoiditis could easily haute been diagnosed by confirming the abnormal distribution of the roots in the dural sac. But the arachnoiditis-like pattern of nerve root distribution in a degenerative disc disease has been regarded as a an incorrect diagnosis of arachnoiditis. The arachnoiditis has been one of the most serious complication in the failed back surgery syndrome. MR images of 32 patients with acute or chronic radicular pain syndrome were investigated by a radiologist and a orthopedc surgeon. 17 patients had lumbar disc herniation; 13 patients, pure spinal stenosis; 2 patients, spondylolisthesis. The discriminant analysis was used to calculate the cutting point of clumping for the abnormal nerve root distribution and to assess the relationship between the arachnoiditis-like pattern of nerve root distribution and other factors According to the result of calculation, the cutting point of clumping In spinal stenosis was 9mm and that in a disc herniation was 6mm. Central clumping of nerve roots in the durn is considered as a characteristic finding at the constricted level of the lumbar degenerative disease. However, the appearance is not a differentiating factor between the adhesive arachnoiditis and constriction in the lumbar degenerative disease. Clinically, the adhesive arachnoiditis should be suspected in the lumbar degenerative disease with the nerve root clumping at multiple level, not associated with remarkable constriction of spinal canal. In the disc herniation with their sagittal diameter over 6mm, the clumping seems to imply the possibility of association with adhesive arachnoiditis.
