What is Arachnoiditis?
Arachnoiditis is the clumping together and tethering of the descending nerves to the inner lining of the water jacket that contains the fluid that supports brain and the cord in the spinal canal.
Myeloscopy is the procedure by the fluid filled space within the water jacket (dura) is explored with the patient in the aware state and able to attest to the presence of pain or symptoms. This clumping is rare and is only symptomatic when the adjacent Dura is inflamed. X-ray analysis at the same time reveals that the position of this inflammation is located at the disc and foramen. It is only found to spread beyond where there has been infection or surgery within the Dura or after massive trauma with significant damage to the bones of the spine. These findings indicate that Arachnoiditis is a response to inflammation in the disc and that this is the source that needs to be treated and with this the symptoms will resolve. This is confirmed by the presence of uninflammed patches of Arachnoiditis which are asymptomatic.
Arachnoiditis Syndrome Sufferers may present with various combinations of back, buttock and leg pain, numbness, muscle weakness and often widespread “Dysaesthaesia”. This takes the form of diffuse often intense pain across the back, spreading up to the thoracic spine, down to involve the sacrum and coccyx, deeply in to the pelvis or perineum and extensively down one or both legs. The symptoms may present as pins and needles, cold or scalding water or a sense of ants crawling up and down the body in these territories. Unfortunately many physicians will reach for a psychological or arachnoiditic explanation for these symptoms. In fact the MRI scan may show the presence of a dehydrated (“Black”) disc possibly with a High Intensity Zone or leaking disc wall tear. The source can be confirmed by Spinal Probing and Discography in the aware state with the symptoms being compounded by the presence of scarring induced by a reaction to these leaking products. Unfortunatelymis-diagnosis prevents such patients from receiving definitive Endoscopic Minimally Invasive Spine Surgery and they usually find themselves referred for palliative chronic pain management.
Neck pain with arm symptoms can also occur on rare occasions. These appear to emanate from inflammation at the lower lumbar spine presumably transmitted through the Posterior Longitudinal Ligament and secondary cervical malposture. This assumption is made because the symptoms settle by treatment of the L4/5 and L5/S1 disc levels by Endoscopic Minimally Invasive Spine Surgery and Muscle Balance Physiotherapy.
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