Doctors Lounge - Orthopedics Answers
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Forum Name: Spinal problems and back pain
|cnelson5266 - Fri Apr 17, 2009 4:20 pm||
45 yo female. Laminectomy 94 to remove cellular schwannoma. No problems since until 7 mos ago - began with slight tightness in L calf upon waking ... progressing periodically to include thigh cramps ... periodic numbness. MRI indicates possible clummping L2-3, L3-4, L4-5 - suspicious for arachnoiditis. 3mm disk bulge at l4-l5, mild central canal stenosis. Moderate degenerative disc disease. Facet degenerrative changes with mild flouroscopic facet joint synovitis. Mild bilaeral neural froraminal stonosis and mild central canal stenosis. Mild facet degenerative changes at L5-S1 with mild bilateral facet joint synovitis.
No pain - mostly numbness and recently leg cramps (taking high blood pressure meds and ibuprofen) ... I'm really concerned about the arachnoiditis. An orthopedic surgeoun thought it was simply scar tissue and gave me arthrotec and that if it didn't improve in 2 weeks to call.
Does anachnoiditis usually present this way ... I can't help but continue to be very worried. Could some of the other changes be causing my symptoms.
Your assistance would be GREATLY appreciated.
|Tom Plamondon PA-C - Mon Apr 27, 2009 10:48 am||
Many of the MRI findings listed as mild are not too alarming and may/may not be contributing to the left leg calf pulling and muscle cramping. For example, conditions like stenosis certainly can cause these symptoms however many people with stenosis are asymptomatic.
The arachnoiditis can be associated with scar tissue development as the result of the laminectomy.
Infection in which case a CBC and constitutional symptoms should be evaluated is also a consideration.
Yes arachnoiditis can present with neurological symptoms (similar to what you desecribed) since the inflammation is located in the sheath housing the spinal cord.
Has there been a consideration that the arachnoiditis could be a early re development of schwannoma?
To assess the peripheral nerves in the legs an EMG and NCV may be helpful. This may help determine if the problem is caused by the nerve tissue or by facet arthritis which may also cause these symptoms.
Take care and let us know how it goes.
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