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Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
Question Title: Arachoiditis, Help Needed:Forum: Neurology Forum
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Re: Arachoiditis, Help Needed:Posted by ccfNeurology MD on June 11, 1997 at 10:46:16: In Reply to: Arachoiditis, Help Needed: posted by Shirlene on June 05, 1997 at 15:09:16: : I am a 37 yr. old mother of 3 and have been diagnoised with Arachnoiditis and Spinal Stenosis along with DDD in the LumbarL4L5 area. I am in desperate need of answers. I have gone to a Neuro. and Orthopedic Doc. for 3 years. Only 3 mon. ago after having a myelogram I was DX with Arachnoiditis. My Doc. has stated to me that he is not comfortable with treating this problem. He feels that a fusion with hardware for the Lumbar DDD would be a good step for me to take. I have been told by so many that I should have NO surgeries. I was sent to another Doc. for a sec. opinion and he too was not comfortable treating my condition. Seem to me that they know little about Arach. and was anxious to hear about all of the Research that I am doing on Arach. I have now decided to wait on surgery. However, I teach school and was hopeing to get some kind of relief before I have to go back to work in Aug. I have so much pain that I can hardly do the things that I must do just to get by. I cannot stand the thought of going back to work in the same condition that I left. I would spend many afternoons laying flat on the floor, just to get SOME relief.I cannot stand, sit or walk for any period of time without severe pain. It seems that my Doctors are really dragging their feet on my condition at my expense. I have ask to be sent to a pain management clinic which my Doc. hesitatedly made an appointment but not until the end of Aug. I cannot go back to work in this conditon. I presently take Vicoden (which I have to beg for], Darvicet, Naprosyn, Flexeril, Elivil and Prozac. None which gives me any great relief. I have in the past tried Theropy consisting of exercise, traction, message etc. I have tried a brace and a TENS unit which were no help either. My Doc. does not want to implanted a stimulator or pump until he does a fusion and sees weather this will work first. I don't know how I got Arach. I have had none of the usual reasons to have gotten Arach. other than trauma to the back several different times. Also have been told that a dics or spur could have made an impression into the spine causing bleeding and leadding to Arach. I need to get relief that I can at least deal with on a daily basis. I need help and I really do need it soon. Please, Anyone with info. that could be of help please answer my message. Thank You for your time. Shirlene
Dear Shirlene, it sounds like you have had a very tough time with your back. The brain and spinal cord is covered by 3 different membranes (called “meninges”): the dura, the arachnoid and the pia mater. The arachnoid membrane lies is the middle membrane. Immediately beneath the arachnoid membrane is the subarachnoid space where the spinal fluid is located, which bathes the brain and spinal cord.. In arachnoiditis, there is proliferation of connective tissue resulting in thickening of the arachnoidal membranes and adhesions between the arachnoid and the dura ( which is the outer membrane). In some cases the subarachnoid space is partially obliterated. In severe cases, the thickened arachnoid membrane can squeeze and strangulate the nerve roots as they exit the spinal cord. The main symptom of arachnoiditis is pain, but there may also be weakness and sensory changes in the extremities. The etiology of arachnoiditis can sometimes be traced to a subacute infection of the meninges/membranes. It can also occur following spinal procedures such as myelograms or spinal surgeries. Some cases have been attributed to spinal injuries but the cause and effect relationship of this is less clear. In many cases, though, no precipitating factor is found. Treatment for arachnoiditis is very difficult. Occasionally, steroids are given , either orally or by injection into the epidural space in the back, but it usually not beneficial. In very special cases, where the arachnoiditis is very localized, surgery can be tried to remove the adhesions. Your back problem is very complicated and unfortunately, I have no immediate answers for you. Going to a Pain Management Program is a very good idea. If you would like to come to the Cleveland Clinic Spine Center for a second opinion, you can call (216) 444-2225. I encourage you to contact The Back Association of America who has an information packet on Arachnoiditis and well as referral servies and support group information. Their address is : PO Box 135, Pasadena MD 21123-0135. Contact person: Margaret Hill, Phone (410) 255-3633, Fax(410) 255-7338. Good luck to you. This information is provided for general medical education purposed only. Please consult your physician for diagnostic and treatment options of your specific medical condition.
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