In the late 1930’s and early 1940’s the myelographic agent Thorotrast, a thorium dioxide solution containing radioactive thorium, was used. This dye produced inflammatory arachnoidal reactions and progressive nerve root damage, leading to cauda equina syndrome and malignant tumors of the nervous system. (11).

Trauma may cause arachnoiditis, and blood in the cerebrospinal fluid, although rare, may produce the disease. (10).

Long reported the advent of myelography and the rapid increase in surgery for diseases of the spine were associated with increasing recognition of arachnoiditis as a complication appearing in the clinical course of rare patients with structural spinal disease.

According to reports, all foreign materials injected into the sub-arachnoid space, including normal saline, produce an inflammatory reaction. All contrast agents that have been and are now employed cause a meningeal inflammatory reaction. However Long questions how significant these reactions are from a clinical standpoint, and whether contrast agent-induced reactions are related to the clinical syndrome of chronic adhesive arachnoiditis. (10)

In 1978, eighty cases of arachnoiditis were identified from a series of 7,600 myelograms. Twenty eight hundred of patients were operated on, and the frequency of arachnoiditis was 1%. Earlier in the century, the disease progressed to paraplegia, but the 1978 report presented a new group of patients who developed arachnoiditis as a complication of a combination of poorly done or multiple myelograms and extensive surgery. The new syndrome commonly occurred in the lumbar region and it did not appear to have the progressive nature described previously. (16).

A 1985 report by Garancis and Haughton studied the development of arachnoiditis using water-soluble contrast.

At first there were no changes and the iodine disappeared within 24 hours. After 8 days, fibrous and perineural adhesions occurred. This was followed by fibrosis of the meninges and dense perineural fibrosis. Progression was evident during the whole twelve weeks of the study .(5)

Don M. Long, a neurosurgeon at the Johns Hopkins School of Medicine in Baltimore, Maryland, has put great effort into studying and compiling information on arachnoiditis. (10) The following is information that has been excerpted from his report. Long’s report ends right before the subtitle “Symptoms of Arachnoiditis” later in this report.

From 1967 to 1992, Long saw a total of 321 patients with arachnoiditis. There were 215 men and 106 women. They ranged in age from 26-72 years old, with the median age being 52 years. In 1967 to 1982, the average number of myelograms was 9 and the range was 1-19. The average number of surgical procedures was 6.5 and the range 0-14. From 1982-1992, the number of myelograms were markedly reduced from 9 to 3 and the number of surgical procedures, from 6.5 to 2.5. There was a small additional group of eight patients with arachnoiditis involving the spinal cord.

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