PubMed · 4999304
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J Miles, Y S Bhandari. 1971. Ossifying spinal arachnoiditis.. https://doi.org/10.1055/s-0028-1090575
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An 11-year-old boy with tuberculous meningitis developed blindness, a rare complication of this disease in the United States. Magnetic resonance imaging demonstrated perichiasmal enhancement, suggesting that arachnoiditis caused the visual loss. Serial neuroimaging over 7 months revealed a persistent inflammatory process in the chiasmatic cistern, hydrocephalus, and progressive cerebral infarctions.
SUMMARY OF BACKGROUND DATA: The authors report a 46-year-old female patient who was referred to this unit for assessment of chronic postsurgical back pain. She reported severe burning pain in the lumbar region accompanied by burning pain and loss of sensation in the lower limbs. She had previously undergone lumbar spinal surgery on three occasions preceded by myelography. METHODS: Examination revealed generalized weakness and hypertonicity of both lower limbs with loss of all sensory modalities below D7. RESULTS: The MRI scanning of the thoracic spine showed an extensive complex syrinx within the thoracic cord. CONCLUSIONS: She underwent syringopleural shunting, and her condition has remained stable.
MRI with intravenous contrast has recently become the imaging modality of choice in the evaluation of patients developing recurrent back pain or symptoms following laminectomy and/or discectomy. The normal postoperative appearance is important to recognize because a number of changes occur normally throughout the healing period. The difference between epidural scar and recurrent disc herniation can usually be determined on MRI. Postoperative fluid collections may also develop. Disc space infection, although uncommon, is a critical diagnosis, but can be confused with degenerative end plate changes. Arachnoiditis and spinal stenosis also show characteristic imaging findings.