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Clumping of Nerve roots and lipoma?
I had a tethered cord release surgery when I was 14 and a laminectomy was performed also. I never had back pain before the surgery (only leg pain) but afterwards I developed bad chronic lower back pain. I had the back pain till my freshman year in college when eventually my upper back and neck started to hurt also. I also started developing twitches in my arms and legs. Once my leg was twitching so bad I went to the ER, where they did an MRI of my lumbar and found nothing, the twitching eventually stopped. Since then my back has always hurt all the time and recently my arms and legs get sharp, dull, aching pains also (not too bad of pain though). I got another MRI of my entire spine recently, and it showed an intervertebral lipoma at the same level of my surgery. associated with the clumping of nerve roots. I have no idea what this means, as the doctor ignored the clumping of nerve roots part. What would cause this and is it causing the pain ? When I google clumping of nerve roots, all I get is links about arachnoiditis, which is scary.. Could that be a possibility? And, why did a lipoma form so recently and quickly on my spine? I have no idea what to do next
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620923 tn?1452919248


  Hi and welcome to the Spinal Cord C/D forum.

  May I ask, do u also have ne other conditions? Like Ehlers-Danlos? The reason I ask is I also have tethered cord along with EDS and Chiari Malformation,...I was scheduled for the release, but my Drs felt I would have more benefit from the posterior fossa decompression with a dura plasty and lamenectomy....the thing I was told with the release is the cord can re-attach, scar tissue can form.

From what I understand about this condition it can arise from surgery, http://jeangodbout.com/pdf/arachnoiditis5.pdfand (per this site )Presently, surgery and myelographic studies are the most common causes. Surgery can
injure the roots and/or the arachnoid membrane directly or indirectly. The injury may
occur in moving the nerve root out of the way to allow access to the disk space, or due
to harsh manipulation and intrathecal bleeding. Arachnoiditis also occurs 10% - 30%
with degenerative disc disease and spinal stenosis. Myelographic tests, in which special
dyes are placed in the fluid around the membranes and roots, followed by an X-ray, can
irritate the arachnoid membranes and lead to arachnoiditis. Using only the latest watersoluble dyes can help prevent this.
Epidural injections of depo medrol may cause arachnoiditis. Based on one study, about
20% of the patients developed arachnoiditis after epidural injections of depo medrol.
There is a belief that a preservative in the anesthesia may have been the causing factor.
Arachnoiditis can be very problematic with chronic neuropathic pain, variable sensory
motor and reflex changes. Usually this arises from nerves entrapped in aracnoid-dural
adhesions. These adhesions can arise from foreign substances introduced into the
subarcahnoid space (anesthesia agents, infections, steroids, dyes etc.). This can also
be from disc herniations or protrusions.
Some of the common and uncommon causes of arachnoiditis are:
· Spinal surgery, especially if there is more than one surgery  
· Chemicals introduced into spinal column  
· Oil based radiographic contrast agents  
· Myelographic studies  
· Spinal drugs: Anesthetics, Steroids, Amphotericin B, Methotrexate  
· Trauma, vertebral injuries, disc herniation  
· Spinal subarachnoid hemorrhage  
· Penetration of spinal column with needles or other foreign objects, including
epidural anesthesia analgesia, or even something as simple as epidural blocks
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I do not believe I have any other conditions. At one point when I was a little kid I was told I had elhers danlos, but that was because I would always turn my ankles and have weak joints (which I believe was instead because of my undiagnosed tethered cord). And yes, that's what I was afraid would happen with the release, is that scar tissue would form, but it doesnt show any on the MRI's, only recently it shows a lipoma in that area. Im not sure if arachnoiditis is what I'm seeing because I had my surgery about 4 years ago. Or if my nerves are just being affected by the lipoma causing all over pain. I dont know. and thank you for your response!
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620923 tn?1452919248

  No worries...u may want to send copies of ur recent and older MRI's to a Chiari specialist as they also treat TCS and mayb could offer insight??

Good Luck
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