Ibrahim George M, Kamali-Nejad Tara, Fehlings Michael G
Division of Neurosurgery and Spinal Program, Krembil Neuroscience Center, Toronto Western Hospital, University of Toronto, Ontario, Canada.
Evid Based Spine Care J. 2010 Aug;1(2):46-51. doi: 10.1055/s-0028-1100914.
The pathophysiology of arachnoiditis ossificans (AO) and its association with syringomyelia remains a rare and poorly understood phenomenon. Here, we present a case of AO associated with syringomyelia, a review of literature, and a discussion of current understanding of disease pathophysiology.
A literature review was performed using MEDLINE (January 1900-May 2010) and Embase (January 1900-May 2010) to identify all English-language studies that described AO with syringomyelia. The current report was added to published cases.
Over 50 cases of AO are reported in literature, of which only eight are associated with syringomyelia. The various presumptive etiologies of syrinx formation include abnormalities in blood circulation, ischemia, hydrodynamic alternations in cerebrospinal fluid (CSF) flow, tissue damage, or incidental coexistence. Changing CSF dynamics related to decreased compliance of the subarachnoid space and subsequent paracentral dissection of the spinal cord may be implicated in the disease process. magnetic resonance imaging (MRI) scanning may identify the syrinx but fail to diagnose the calcified arachnoid. Five patients, including the current case, improved clinically following laminectomy and decompression.
Syringomyelia in association in AO is a rare phenomenon. A high index of suspicion is required and both MRI and computed tomography (CT) are recommended for diagnosis. The pathophysiology of syringomyelia in AO remains an area of ongoing research.
骨化性蛛网膜炎（AO）的病理生理学及其与脊髓空洞症的关联仍然是一种罕见且了解甚少的现象。在此，我们报告一例AO合并脊髓空洞症的病例，回顾相关文献，并讨论目前对该疾病病理生理学的认识。
使用MEDLINE（1900年1月至2010年5月）和Embase（1900年1月至2010年5月）进行文献综述，以确定所有描述AO合并脊髓空洞症的英文研究。将本报告纳入已发表的病例中。
文献报道了50多例AO病例，其中仅8例与脊髓空洞症相关。脊髓空洞形成的各种推测病因包括血液循环异常、缺血、脑脊液（CSF）流动的流体动力学改变、组织损伤或偶然并存。与蛛网膜下腔顺应性降低相关的CSF动力学改变以及随后脊髓中央旁解剖可能与疾病过程有关。磁共振成像（MRI）扫描可识别脊髓空洞，但无法诊断钙化的蛛网膜。包括本病例在内的5例患者在椎板切除减压术后临床症状改善。
AO合并脊髓空洞症是一种罕见现象。需要高度怀疑，建议使用MRI和计算机断层扫描（CT）进行诊断。AO中脊髓空洞症的病理生理学仍然是一个正在研究的领域。
