Journal List > J Korean Orthop Assoc > v.54(4) > 1130643

Jeon, Hwang, Suh, and Kim: Cauda Equina Syndrome Occurred by Adhesive Arachnoiditis of the Lumbar Spine with an Unknown Cause


Spinal adhesive arachnoiditis is an inflammation and fibrosis of the subarachnoid space and pia mater caused by infection, trauma, spinal vascular anomalies, and iatrogenic (surgery and/or puncture). Adhesive arachnoiditis develops various symptoms and signs (gait disturbances, radiating pain, paralysis, and incontinence). On the other hand, adhesive arachnoiditis associated with cauda equina syndrome has not been reported in Korea until now. The authors experienced cauda equina syndrome caused by adhesive arachnoiditis of the lumbar spine with satisfactory results following decompression. We report this case with a review of the relevant literature.

Figures and Tables

Figure 1

Preoperative magnetic resonance imagings (MRIs) show adhesive arachnoiditis. (A) Gadolinium-enhanced T1-weighted sagittal MRI shows dural enhancement from the L4–5 disc space level to the S2 level (arrow). (B) T2-weighted axial MRIs show clumping of the nerve roots (arrows).

Figure 2

Intraoperative photographs. (A) Fibrous tissue fragments removed from adhesive arachnoiditis. (B) Severe adhesion of the soft tissue and pale dura were resolved after decompression and laminectomy at the L5/S1/2 level.

Figure 3

Microscopic examination of dense fibrous tissue from adhesive arachnoiditis shows mild chronic inflammation with calcification (H&E, ×40).

Figure 4

One month later, follow-up magnetic resonance imagings (MRIs). (A) Gadolinium-enhanced T1-weighted sagittal MRI shows no more dural enhancement (arrows). (B) T2-weighted axial MRIs show resolved clumping nerve roots (arrows).



CONFLICTS OF INTEREST The authors have nothing to disclose.


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Ho-Seung Jeon

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