CLASSIFICATION

Brenner classification of arachnoiditis (1978):

• 0.Extradural compression (spondylosis/stenosis)
• 1.local post-operative changes
• 2.arachnoiditis at a single level
• 3.arachnoiditis at multiple levels
• 4.myelographic block secondary to arachnoiditis
• 5.arachnoiditis progressive or ascending greater than 2 levels above operative site.

The radiologists classify arachnoiditis according to Delamarter’s MRI classification:

• Type I: central clumping of nerve roots
• Type II: peripheral adhesion of nerve roots to the theca (“empty sac”)
• Type III: complete opacification of the thecal sac, extending over at least one vertebral level

Table of Contents

Introduction
THE SCALE OF THE PROBLEM
ARACHNOIDITIS OR EPIDURAL FIBROSIS?
NOMENCLATURE
THE INFLAMMATORY NATURE OF ADHESIVE ARACHNOIDITIS
PATHOLOGY
CLASSIFICATION
NEXT: CAUSES
THE IATROGENIC ASPECT OF ADHESIVE ARACHNOIDITIS
PRESERVATIVES IN SPINAL INJECTIONS
PROGNOSIS
THE SYNDROMIC NATURE OF SYMPTOMS IN ADHESIVE ARACHNOIDITIS (Warning: LONG)
COMPLICATIONS OF ADHESIVE ARACHNOIDITIS
DIFFERENTIAL DIAGNOSIS
CLINICAL ASSESSMENT
DIAGNOSTIC TESTS
TREATMENT OPTIONS (Warning: LONG)
MULTIPLE CHEMICAL SENSITIVITY
LOOKING TO THE FUTURE
APPENDIX I: AUTOIMMUNE ASPECTS
APPENDIX II: SYRINGOMYELIA
ADDENDUM - May 2000
REFERENCES