Endoscopic treatment of lumbar arachnoiditis.
OBJECTIVE
The diagnosis of lumbar arachnoiditis remains complex and often inconclusive. Using the technique of lumbar subarachnoidal endoscopy (thecaloscopy), the pathology can be identified and the patient treated with long-term effects on the symptoms.


METHODS
Endoscopic operations were performed on 23 patients suffering from varying symptoms with an enlarged lumbar subarachnoidal space. Having confirmed the diagnosis of lumbar arachnoiditis, a number of endoscopic operations ranging from adhesiolysis to subarachno-epidurostomy were carried out.


RESULTS
Radicular symptoms in lumbar arachnoiditis were successfully relieved by various endoscopic dissection techniques, such as restoration of the improved CSF flow by subarachno-epidurostomy along the rootlet. This has been identified as one of the causal factors of the clinical symptoms. In cases where lumbar pain persists in spite of a previous thecaloscopy, further treatment with a lumboperitoneal shunt device has proved most successful.
Warnke
J P
JP
Department of Neurosurgery, Paracelsus Hospital, Zwickau, Germany. dr.jan-peter.warnke@pk-mx.de
Mourgela
S
S
D000328:Adult; D000368:Aged; D001100:Arachnoiditis / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*; D002555:Cerebrospinal Fluid / Q000502:physiology; D005260:Female; D006801:Humans; D008161:Lumbosacral Region; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D044583:Neuroendoscopy / Q000379:methods*; D013346:Subarachnoid Space