Steel Christopher J, Abrames Erik L, O'Brien William T
Department of Radiology, David Grant USAF Medical Center, Travis AFB, CA, USA.
Department of Radiology, David Grant USAF Medical Center, Travis AFB, CA, USA ; Department of Radiology, University of California, Davis School of Medicine, Sacramento, CA, USA.
Open Neuroimag J. 2015 Aug 31;9:13-20. doi: 10.2174/1874440001509010013. eCollection 2015.
Arachnoiditis ossificans is a rare cause of chronic, progressive myelopathy. In contrast to the more common benign causes of meningeal calcification, arachnoiditis ossificans results in replacement of portions of the spinal arachnoid by bone as an end-stage complication of adhesive arachnoiditis. It is usually the sequela of prior trauma or interventional procedures. Prognosis and treatment options depend upon the location and degree of spinal stenosis with thoracic involvement being more common and more severe than lumbar spine involvement. The imaging findings on magnetic resonance imaging may be confusing; however, the findings of intraspinal ossification on computed tomography are characteristics and diagnostic. We present a classic case of arachnoiditis ossificans in an elderly man who presented with progressive myelopathy and a recent fall, along with a review of the literature. The imaging in this case not only identified the characteristic findings of arachnoiditis ossificans but also identified secondary findings of the underlying causative etiology.
骨化性蛛网膜炎是慢性进行性脊髓病的罕见病因。与更常见的良性脑膜钙化病因不同,骨化性蛛网膜炎作为粘连性蛛网膜炎的终末期并发症,会导致脊髓蛛网膜的部分被骨替代。它通常是先前创伤或介入性操作的后遗症。预后和治疗选择取决于脊柱狭窄的部位和程度,胸椎受累比腰椎受累更常见且更严重。磁共振成像的影像学表现可能令人困惑;然而,计算机断层扫描上的椎管内骨化表现具有特征性且可用于诊断。我们报告一例老年男性骨化性蛛网膜炎的典型病例,该患者表现为进行性脊髓病和近期跌倒,并对相关文献进行综述。该病例的影像学检查不仅明确了骨化性蛛网膜炎的特征性表现,还明确了潜在病因的继发性表现。