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2015 ; 6
(Suppl 24
): S608-10
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Arachnoiditis ossificans and syringomyelia: A unique presentation
#MMPMID26693389
Opalak CF
; Opalak ME
Surg Neurol Int
2015[]; 6
(Suppl 24
): S608-10
PMID26693389
show ga
BACKGROUND: Arachnoiditis ossificans (AO) is a rare disorder that was
differentiated from leptomeningeal calcification by Kaufman and Dunsmore in 1971.
It generally presents with progressive lower extremity myelopathy. Though the
underlying etiology has yet to be fully described, it has been associated with
various predisposing factors including vascular malformations, previous
intradural surgery, myelograms, and adhesive arachnoiditis. Associated conditions
include syringomyelia and arachnoid cyst. The preferred diagnostic method is
noncontrast computed tomography (CT). Surgical intervention is still
controversial and can include decompression and duroplasty or durotomy. CASE
DESCRIPTION: The authors report the case of a 62-year-old male with a history of
paraplegia who presented with a urinary tract infection and dysautonomia. His
past surgical history was notable for a C4-C6 anterior fusion and an intrathecal
phenol injection for spasticity. A magnetic resonance image (MR) also
demonstrated a T6-conus syringx. At surgery, there was significant ossification
of the arachnoid/dura, which was removed. After a drain was placed in the syrinx,
there was a significant neurologic improvement. CONCLUSION: This case
demonstrates a unique presentation of AO and highlights the need for CT imaging
when a noncommunicating syringx is identified. In addition, surgical
decompression can achieve good results when AO is associated with concurrent
compressive lesions.