Patterns of Intrathecal Ossification in Arachnoiditis Ossificans: A Retrospective Case Series.

TitlePatterns of Intrathecal Ossification in Arachnoiditis Ossificans: A Retrospective Case Series.
Publication TypeJournal Article
Year of Publication2023
AuthorsThejeel B, Geannette CS, Roytman M, Pisapia DJ, Chazen JL, Jawetz ST
JournalAJNR Am J Neuroradiol
Date Published2023 Feb
KeywordsArachnoiditis, Humans, Magnetic Resonance Imaging, Osteogenesis, Retrospective Studies, Tomography, X-Ray Computed

Arachnoiditis ossificans is an uncommon end-stage appearance of chronic adhesive arachnoiditis. Imaging features of arachnoiditis ossificans are characteristic and should be diagnosed to avoid unnecessary intervention and guide prognosis and management. In this case series, we retrospectively analyzed CT and MR imaging of 41 patients to identify common patterns of intrathecal ossification and present the common etiologies. Thirty-two patients had a confirmed history of spinal instrumentation, 7 were discovered on imaging without prior surgical history, 1 had a history of ankylosing spondylitis, and 1 had trauma. The most frequent site of ossification was at the conus and cauda equina. Four patterns of ossification were identified, including central, nerve root encasing, weblike, and peripheral. Arachnoiditis ossificans is an important, likely under-recognized consideration in patients who present with back pain. Diagnosis can be made readily on CT; MR imaging diagnosis is also possible but may be challenging.

Alternate JournalAJNR Am J Neuroradiol
PubMed ID36635055
PubMed Central IDPMC9891321
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