Arachnoiditis

Diagram of arachnoid

Symptoms, Causes, Treatments

Arachnoiditis (Arachnitis) is a rare, painful condition that may be responsible for failed back surgery syndrome, or FBSS. It was once the second most common cause of pain after back surgery, triggered by a type of dye that was used to view the spine. Although the dye is no longer a part of spine surgery, it is still possible to develop arachnoiditis symptoms, and ultimately struggle again with chronic pain.

What Is Arachnoiditis?

There are three membranes that protect your spinal cord. These are:

  • Dura Mater (the outer membrane)
  • Arachnoid Mater (the middle membrane)
  • Pia Mater (the inner membrane)

If the term “arachnoid” sounds familiar, it is because the term “arachnid” means “spider.” This is not a coincidence, as that middle membrane, the arachnoid membrane, has a variety of nerves that are attached together like a web. Arachnoiditis is inflammation of the arachnoid mater.

During and after back and neck surgery, it’s possible that damage to or near the arachnoid space can cause inflammation. If the arachnoid mater becomes inflamed, and scar tissue develops, the nerves start to clump together. This can permanently alter the crucial nerves in the spinal cord, and possibly lead to the development of:

  • Pain (Usually Takes 6+ Months to Develop)
  • Hot or Cold Water Sensations
  • Tingling/Pins and Needles
  • Crawling Sensations

Pain may be radiating or localized. In very rare cases, arachnoiditis can cause pain or strange sensations throughout the entire body.

Arachnoiditis can have many causes – some unrelated to spine surgery. Trauma, like a motorcycle accident, can trigger arachnoiditis. But spine surgery, especially multiple surgeries, does carry a risk of developing the disease. This condition may also be referred to as “adhesive arachnoiditis,” to differentiate it from non-surgical causes.

The most common causes of arachnoiditis after back surgery include:

  • Dural Tears – Tears to the dural mater can leak cerebrospinal fluid (CSF) that may cause arachnoiditis to develop. Treatment for dural tears, including blood patches, can also lead to arachnoiditis if the blood patch was injected too deep in the dural mater.
  • Spine Infection – Spine infections after surgery have the potential to damage the spinal membranes, and possibly contribute to arachnoiditis.
  • Direct Tear – Similar to a dural tear, it possible for a surgical error to directly tear the arachnoid space. This, in turn, can lead to arachnoiditis as well.

It should be noted that the exact cause of post-surgical arachnoiditis in patients with failed back surgery syndrome may not be well known. Some patients with arachnoiditis may also have no symptoms.

Treatment For Arachnoiditis After Surgery

Post laminectomy arachnoiditis does not currently have a cure. Direct surgery on the arachnoiditis is not always recommended, because it runs the risk of additional scar tissue. Arachnoiditis treatments are instead focused on management, such as medications and steroid injections.

But in some cases, surgery may be necessary. It may be worth exploring a spinal cord stimulator implant, or a decompression surgery aimed at reducing some of the more severe pain.

At Spine Center Atlanta, our specialists are available to provide comprehensive support for revision spine surgery and FBSS treatments, including for arachnoiditis. We help both local and national patients receive the support they need to manage and overcome their chronic pain. For more information, please call us today at 404-620-5523.

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