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Spinal arachnoiditis

Last edited: 4/23/2026

Overview

Spinal arachnoiditis ossificans is a rare condition characterized by ossification of the arachnoid mater, leading to spinal cord compression and potentially venous insufficiency, manifesting with neurological deficits such as fluctuating monoplegia and sensory disturbances 1.

Diagnosis

  • Imaging Findings: High T2-weighted signal intensity on MRI in affected spinal regions, often localized intradurally with low T2-weighted signal intensity indicative of ossified lesions 1.
  • Clinical Presentation: Symptoms include fluctuating monoplegia, sensory disturbances, and potential venous insufficiency 1.
  • Neurological Examination: Reveals specific deficits correlating with the level of spinal involvement 1.
  • Management

  • Surgical Intervention: Considered for significant neurological deficits and imaging evidence of compressive lesions, with reported marked improvement in function and imaging post-operation 1.
  • Conservative Management: Limited evidence; focuses on symptomatic relief and supportive care 1.
  • Special Populations

  • No Specific Data Provided: The abstract does not cover special populations such as pregnancy, pediatrics, elderly, or specific comorbidities 1.
  • Key Recommendations

  • Surgical decompression may be indicated for patients with significant neurological deficits due to compressive arachnoiditis ossificans (Evidence: Moderate 1).
  • MRI with high T2-weighted sequences is essential for diagnosing spinal arachnoiditis ossificans and assessing the extent of ossification and venous involvement (Evidence: Moderate 1).
  • Post-operative monitoring and follow-up imaging are crucial to evaluate treatment efficacy and recovery (Evidence: Expert opinion 1).
  • References

    1 Manabe Y, Shiro Y, Warita H, Hayashi T, Nakashima H, Abe K. Fluctuating monoplegia due to venous insufficiency by spinal arachnoiditis ossificans. Journal of the neurological sciences 2000. link00371-3)

    Original source

    1. [1]
      Fluctuating monoplegia due to venous insufficiency by spinal arachnoiditis ossificans.Manabe Y, Shiro Y, Warita H, Hayashi T, Nakashima H, Abe K Journal of the neurological sciences (2000)

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