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Case Reports
. 2015 Sep 10;3(1):5-8.
doi: 10.2176/nmccrj.cr.2015-0140. eCollection 2016 Jan.

A Case of Lumbosacral Arachnoiditis Ossificans

Yuichi Kasai  1 , Takao Sudo  2 , Toshihiko Sakakibara  1 , Koji Akeda  2 , Akihiro Sudo  2
Affiliations
Case Reports

A Case of Lumbosacral Arachnoiditis Ossificans

Yuichi Kasai et al. NMC Case Rep J. .

Abstract

The patient was a 13-year-old boy who complained of pain in both buttocks. Plain and reconstructive computed tomography (CT) images showed an ossified lesion within the dura mater at the L5-S2 levels, and arachnoiditis ossificans in the lumbosacral area was suspected. In the operative findings obtained after cutting the dura, a bone fragment 4.5 × 0.5 × 0.5 cm in size was observed in the center of the strongly adhesive nerve bundle of the cauda equina, which was removed en bloc. The postoperative clinical course of the patient was excellent. The case, along with a review of literature is presented.

Keywords: arachnoiditis ossificans; cauda equina; lumbosacral spine; surgery.

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Conflict of interest statement

Conflicts of Interest Disclosure No funds were received in support of this work. No benefits in any form have been or will be received from any commercial party related directly to the subject of this manuscript. Informed consent of the patient for the use of this information was obtained, and this publication was performed with the approval (No. 2930) of the ethics committee of our university.

Figures

Fig. 1
Fig. 1
Magnetic resonance imaging (MRI) showed no distinct abnormalities on a T1-weighted image (A), but showed an irregular image with a mix of low and high signals at L5 vertebra or lower on a T2-weighted image (B).
Fig. 2
Fig. 2
Plain computed tomography (CT) at L5/S1 level (A) and reconstructive CT images at the L5–S2 level (B) showed an ossified lesion within the dura mater.
Fig. 3
Fig. 3
A bone chip 4.5 × 0.5 × 0.5 cm in size was found in a bundled state of the nerves of the cauda equina, which was removed en bloc.
Fig. 4
Fig. 4
Histological observation of the harvested bone chips showed a normal osseous structure.
Fig. 5
Fig. 5
Computed tomography reconstruction images obtained 2 years after surgery showed no ossified lesions.
See this image and copyright information in PMC

References

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