The Aword

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It has been suggested in early articles about arachnoiditis that the first mention of the phenomenon of adhesive arachnoiditis was published in 1893 by Quinke, who described a case and outlined the acute and chronic phases of the condition.

In 1897, Schwarz ([i]) wrote about arachnoiditis due to syphilis, listing some symptoms and signs, whilst in 1909, the British surgeon Horsley discussed diagnosis and treatment of "Chronic spinal meningitis."([ii])

Later, in 1926, in a French medical article entitled ""La My?lite n?crotique subaigu?", Foix and Alajouanine described autopsy cases of spinal arteriovenous malformations which bled into the local areas and caused arachnoiditis.

(Blood is a potent irritant to nervous tissue). Progression of the inflammation led to spinal cord damage and paralysis. The syndrome, named after the authors, tended to occur in the thoracic region of the spine. 

The term arachnoiditis refers to inflammation of the arachnoid layer of the meninges - the membranes around the spinal cord and nerve roots.

The spinal meninges are in 3 layers, dura, arachnoid and pia. The arachnoid layer of the meninges is part of the leptomeninges, the pia being the other.

There have been numerous other terms used, including chronic leptomeningitis, arachnoiditis adhesiva circumscripta, arachnitis, serosa circumscripta spinalis, chemical meningitis, intraspinal granulomatosis and chronic spinal meningitis.

Anatomical or radiological arachnoiditis, (i.e. ?silent', without symptoms) may be relatively commonplace in anyone who has had direct insult (mechanical or chemical) to the arachnoid membrane.

Furthermore, within certain patient populations, notably those with Failed Back Surgery Syndrome (FBSS), adhesive arachnoiditis is more prevalent than many doctors realise;

Burton reported as early as 1978([iii]) that it is

"common in patients with severe back and/or leg pain and functional impairment due to the failed back surgery syndrome."

[i] Schwarz E: Wein Klin Wochenschr 1897; 10: 177 [Syphilitsche myelomeningitis mit holenbildung in ruchenmarke and besodneren degenerativen veranderum gen der neurologica].


[ii] Horsley V Brit Med J 1909; 1: 513-517 Chronic spinal meningitis: its differential diagnosis and surgical treatment.

[iii] Burton CV Spine 1978 Mar; 3(1): 24-30 Lumbosacral arachnoiditis