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arachnoiditis

Inflammation of the arachnoid membrane often with involvement of the subarachnoid space. Etiology: 1) irritation from chemicals 2) infection from bacteria or viruses 3) direct injury to the spine a) chronic compression of spinal nerves b) complications from spinal surgery or other invasive spinal procedures Pathology: - inflammation can result in formation of scar tissue & adhesions which cause spinal nerves to adhere to each other Clinical manifestations: 1) no consistent pattern of symptoms 2) numbness, paresthesias &/or burning pain in the lower back or legs Management: 1) most treatments focused on a) pain relief b) improvement of symptoms that impair daily function c) physiotherapy, exercise, & psychotherapy often recommended 2) glucocorticoid injections (need clinical trials) 3) transcutaneous electrical nerve stimulation (need clinical trials) 4) surgical intervention is controversial outcomes are generally poor & provide only short-term relief 5) prognosis a) chronic pain disorder that is not progressive b) does not improve significantly with treatment c) long-term outcomes are unpredictable

Specific

lumbar adhesive arachnoiditis

General

meningitis

References

  1. Stedman's Medical Dictionary 27th ed, Williams & Wilkins, Baltimore, 1999