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Final Program

906 - A Presentation of Arachnoiditis Following Spinal Cord Stimulator Implant: A Case Report

Friday, February 28, 2025
5:00 PM - 6:30 PM MST

    Presenting Author(s)

  • KP

    Kevin Paul, DO

    Physician
    Mercy Hospital
    Rockville Centre, New York, United States

    • Co-Author(s)

  • SB

    Samira Bahrami Tabar, MD/DO

    Resident Physician
    Jefferson Einstein Residency Program
    Philadelphia, Pennsylvania, United States

  • VS

    Vasanth Selvam, DO

    Physician Resident
    Mercy Hospital
    Floral Park, New York, United States

  • PS

    Perry Stein, MD

    Physician
    Mercy Hospital
    Rocville Centre, New York, United States

Case Diagnosis: Arachnoiditis after Spinal Cord Stimulator

Case Description: A 61-year-old female presented after a motor vehicle accident in 2004, experiencing sharp, constant pain radiating to the right lower extremity. She underwent a spinal cord stimulator implant on December 4, 2023. Post-procedure, she developed urinary frequency, incontinence, worsening numbness, and bilateral lower extremity tremors. Initial MRI findings revealed multilevel degenerative changes in the cervical spine (most pronounced at C5-C6), thoracic spine changes, and chronic alterations at L4-L5 and L5-S1, with no evidence of postoperative complications. Four days later, the spinal cord stimulator was removed, and Decadron was initiated for possible spinal cord injury. A repeat MRI indicated signs suggestive of arachnoiditis. The patient received supportive care, Decadron, pain management, and aggressive physical therapy. Upon initial physical therapy evaluation the patient ambulated 15 feet via rolling walker with moderate assistance of 2 however after vigorous physical therapy her functional status improved to 150 feet via rolling walker with minimum assistance

Discussions: Arachnoiditis is a rare but significant inflammatory condition affecting the arachnoid membrane, one of the three layers of protective tissue surrounding the spinal cord and brain. Arachnoiditis can severely affect neurological function and quality of life, leading to debilitating symptoms such as mobility issues and radicular pain.  It can result from various causes, including traumatic injury, surgical procedures, or infections. In this case, the development of arachnoiditis after spinal cord stimulator implantation illustrates the potential complications associated with spinal interventions.

Conclusions: Current treatments involve pain management, physical therapy, and corticosteroids to reduce inflammation. Physical therapy is crucial, not only for pain relief but also for improving functional mobility and independence. Given the potential for devastating outcomes, further research into effective treatment strategies for arachnoiditis is essential to optimize patient care and recovery outcomes.