SPINAL ARACHNOIDITIS AS A COMPLICATION OF EPIDURAL-ANESTHESIA

Seven patients who received epidural anesthesia for gynecological (5 c ases), cosmetic (1 case) or general surgery (1 case) developed spinal arachnoiditis leading to subarachoid cyst in all 7 and cord cavitation in 5. MRI was useful to show the subarachnoid and intramedullary cyst s, as well as to monitor lesion extent and progress. Associated MRI fi ndings were a Chiari anomaly in one case, a tethered cord in another a nd spinal cord atrophy in a third. One patient refused surgery but imp roved spontaneously while the other six were treated by a shunting pro cedure, with a satisfactory outcome in three. Meningeal inflammation m ay have left scars which later induced ischemia and subsequent cavitat ion. Alternatively, CSF circulation blockade may have dilated the cent ral spinal canal causing ischemia by compression, followed by myelomal acia and cavitation. Careful handling of this procedure is urged in or der to avoid such severe complications.