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Research ArticleSpine

Patterns of Intrathecal Ossification in Arachnoiditis Ossificans: A Retrospective Case Series

B. Thejeel, C.S. Geannette, M. Roytman, D.J. Pisapia, J.L. Chazen and S.T. Jawetz
American Journal of Neuroradiology February 2023, 44 (2) 228-234; DOI: https://doi.org/10.3174/ajnr.A7764
B. Thejeel
aFrom the Department of Radiology and Diagnostic Imaging (B.T.), University of Alberta, Edmonton, Alberta, Canada
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C.S. Geannette
bDepartment of Radiology and Imaging (C.S.G., J.L.C., S.T.J.), Hospital for Special Surgery, New York, New York
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M. Roytman
cDepartment of Radiology (M.R), New York-Presbyterian Hospital, Weill Cornell Medicine, New York, New York
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D.J. Pisapia
dDepartment of Pathology and Laboratory Medicine (D.J.P.), Weill Cornell Medicine, New York, New York
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J.L. Chazen
bDepartment of Radiology and Imaging (C.S.G., J.L.C., S.T.J.), Hospital for Special Surgery, New York, New York
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S.T. Jawetz
bDepartment of Radiology and Imaging (C.S.G., J.L.C., S.T.J.), Hospital for Special Surgery, New York, New York
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Abstract

SUMMARY: Arachnoiditis ossificans is an uncommon end-stage appearance of chronic adhesive arachnoiditis. Imaging features of arachnoiditis ossificans are characteristic and should be diagnosed to avoid unnecessary intervention and guide prognosis and management. In this case series, we retrospectively analyzed CT and MR imaging of 41 patients to identify common patterns of intrathecal ossification and present the common etiologies. Thirty-two patients had a confirmed history of spinal instrumentation, 7 were discovered on imaging without prior surgical history, 1 had a history of ankylosing spondylitis, and 1 had trauma. The most frequent site of ossification was at the conus and cauda equina. Four patterns of ossification were identified, including central, nerve root encasing, weblike, and peripheral. Arachnoiditis ossificans is an important, likely under-recognized consideration in patients who present with back pain. Diagnosis can be made readily on CT; MR imaging diagnosis is also possible but may be challenging.

ABBREVIATION:

AO
arachnoiditis ossificans
  • © 2023 by American Journal of Neuroradiology
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American Journal of Neuroradiology: 44 (2)
American Journal of Neuroradiology
Vol. 44, Issue 2
1 Feb 2023
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Patterns of Intrathecal Ossification in Arachnoiditis Ossificans: A Retrospective Case Series
B. Thejeel, C.S. Geannette, M. Roytman, D.J. Pisapia, J.L. Chazen, S.T. Jawetz
American Journal of Neuroradiology Feb 2023, 44 (2) 228-234; DOI: 10.3174/ajnr.A7764

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Patterns of Intrathecal Ossification in Arachnoiditis Ossificans: A Retrospective Case Series
B. Thejeel, C.S. Geannette, M. Roytman, D.J. Pisapia, J.L. Chazen, S.T. Jawetz
American Journal of Neuroradiology Feb 2023, 44 (2) 228-234; DOI: 10.3174/ajnr.A7764
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