What is the most common postoperative complication of spinal surgery?
Arachnoiditis is commonly seen in the cauda equina after lumbar surgery, myelography using oil-based dye, and even intrathecal injections.
It results in the adhesion and clumping of the nerve roots to each other and in turn results in radicular type pain, paresthesias, weakness, and sphincter dysfunction.
MRI may show thickening and clumping of the nerve roots, adherence of roots to the thecal sac with enhancement, and loculations of spinal fluid.
Surgical debridement and epidural and intrathecal steroid injections have been attempted as treatment, but none have shown efficacy. In fact, these techniques may even worsen the condition.
Thus, treatment is mainly symptomatic.