arachnoiditis does not prelude a good result if the indications for the procedure are present.

Surgery: Long reserves surgery for the small number of patients with progressive neurological deficits or a fixed deficit that is incapacitating, or for those few patients with believable intractable pain for whom nothing else seems to work.

He uses CT myelogram because he feels MRI does not sufficiently show the normal areas above and below the abnormality and the full extent of and location of the arachnoiditis. Scars that are posteriorly placed are most favorable and napkin ring lesions are next. When the entire canal is filled with scar, the surgery is likely to be unsuccessful, and the presence of calcifications means surgery is going to be difficult even for this extremely demanding surgery. It is the most tedious, time consuming, and meticulous dissection that neurosurgeons do. It requires the dissection of individual nerves from dense scar under high magnification. The roots are easily injured and only the most careful dissection will allow them to be extricated from the scar. Patients are likely to worsen during the process.

Long feels that before a surgeon undertakes this kind of surgery, the patient was to be told of the potential results, risks, and magnitude of the procedure. Despite all of this, the doctor feels the operation is gratifying and will often preserve or restore function in patients who are losing neurological capabilities.

Arachnoiditis calcifications is a particularly difficult problem. If a calcified mass is posteriorly placed, it can be dissected out with ease. But when calcifications are scattered, the surgical challenge is even greater than usual. Typically, the nerves enter and exit the calcified masses. To obtain adequate decompression, it is necessary to break the calcium, dissect the calcified masses away from the nerves, and remove them leaving the nerves intact. Sometimes it will not be possible to free the roots from calcified scar, so the surgery should be stopped to prevent undue risk of increasing the patients’ neurological deficits.

SYMPTOMS OF ARACHNOIDITIS:

There is no cure for arachnoiditis, but many of the symptoms can be treated. There are some symptoms that are more common than others. Below is a list of both the common (*) and uncommon symptoms. They are:

*Back Pain—A feeling of severe pressure in the lumbar spine, especially after standing or walking. The burning pain is difficult to treat and usually radiates into one or both legs.

*Foot Pain—There is a feeling as if one us walking on rocks or broken glass. There may be severe burning in the feet and ankles. Some people use ice to “cool” these areas, but the skin must be protected so a cloth or towel should be placed between the skin and ice pack.

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