Objective: This case report describes the clinical features, complications, imaging characteristics, and management of postoperative spinal adhesive arachnoiditis.
Clinical Features: A 54-year-old woman presented with right posterior thigh and leg pain after a lumbar spine fusion surgery to correct a degenerative spondylolisthesis of L3/4. Her pain was sharp and shooting and worsened with knee extension. A lumbar computed tomography myelogram demonstrated clumping and adhesion of the nerve rootlets in the cauda equina at the surgical fusion levels. Findings were consistent with spinal arachnoiditis.
Intervention and Outcome: The patient was treated with 2 sets of neural mobilization of the sciatic nerve with 15 repetitions each. Treatment was provided 2× per week for 3 weeks. The patient used the neural mobilization exercises at home and performed to tolerance. The patient’s Oswestry Questionnaire was reduced significantly by 19% with decreased pain intensity of 2 points on the verbal analogue scale.
Conclusion: Neural mobilization was used successfully in the management of a patient with postoperative spinal arachnoiditis.
Author keywords: Arachnoiditis; Failed Back Surgery Syndrome; Magnetic Resonance Imaging; Myelography; Chiropractic
Author affiliations: SMC, NWK: Radiology Department, Logan University, Chesterfield, Missouri; EDJ: Chiropractic Health Centers, Logan University, Chesterfield, Missouri
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