Arachnoidits 

(adhesive arachnoiditis)


Arachnoiditis is an inflammation of the arachnoid that changes it into a denser, thicker consistency that can cause tissues (such as the dura around nerve roots and the thecal sac) to stick together. Scarring in the arachnoid space around the lumbar nerve roots tethers them so that they do not move normally with movements of the vertebral column and muscles of the spine. The tethered roots are stretched by movement which irritates them and can cause pain.

Arachnoiditis is a frequently invoked "cause" of the chronic nerve root pain that afflicts some patients who have undergone procedures in the lumbar spinal canal (such as lumbar laminectomy for decompression or microdiscectomy) many of whom also carry the diagnosis: "Failed back".  

Pathophysiology of arachnoiditis

Epidural fibrosis

Failed back syndrome

Decompressive lumbar laminectomy - (Risks and complications of lumbar laminectomy)

Lumbar microdiscectomy - (Risks and complications of microdiscectomy)

Spinal disorders Specialty Center

 

The dura (green "d") is held back by blue stitches.  The spinal cord at the level of the yellow arrow appears normal (pink).  At the level of the blue arrow the arachnoid is scarred (white).

Photo  M Wang MD  USC Neurosurgery

figure: arachnoiditis MR

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Response to question about adhesive arachnoiditis:

The answer to your questions about lumbar sympathetic rhizotomy and adhersive arachnoidits is easy: No. 
The sympathetic nerve roots (rhizo = root in Greek or Latin, otomy = cutting of) are inside your abdominal cavity wheres the spinal nerve roots (the ones that are surrounded by adhesive arachnoiditis are in the spinal canal.  Radiofrequency and phenol are not used intraspinally.  The adhesive arachnoidis is a complication of the lumbar laminectomy you had in the past and not of the lumbar sympathetic rhizotomy..