Medical Protocol for Arachnoiditis by Dr Forest Tennant

Arachnoiditis is an under diagnosed rare disease. The most of the cases are iatrogenic, we can say caused by doctors, but as well a trauma, bacteria, a virus and some neurological diseases can cause arachnoiditis.

Dr Forest Tennant has published a very clear and understandable bulletin material packet. It is printable, and you can help us by sharing the basic knowledge about arachnoiditis and the first aid treatment protocol by  printing the bulletin material packet. Please share it with your pain clinic and doctor visits.

Welcome-to-Aracnoiditis-Bulletin

Bulletin-1-Definitions-Used

Bulletin-2-Why-a-need-for-the-arachnioditis-bulletinBulletin-12-Emergency-Treatment-for-Arachnoiditis

Bulletin-12-Emergency-Treatment-for-Arachnoiditis

Bulletin-13-Screening-for-AA

contact  information

Forest Tennant M.D., Dr. P.H. 
Veract Intractable Pain Clinic
338 S. Glendora Ave.
West Covina, CA 91790-3043

Clinic Ph: 626-919-0064
Clinic Fax: 626-919-0065
Office Ph: 626-919-7476
Office Fax: 626-919-7497
E-mail: veractinc@msn.com

More about treating arachnoiditis and pain you will find from these

links to web sites

www.foresttennant.com 

www.hormonesandpaincare.com

Arachnoiditishope.com

Have a wonderful day !

PS: Leave us a comment if there is anything in your mind. This hole page is under a bigger facelifting process as much adhesive archnoiditis allows us work.

Aracnoiditis Adhesiva Lumbo-Sacra

The article removed to Aracnoiditis España

 

 

 

Acute management of arachnoiditis

There is a huge difference between arachnoiditis and adhesive arachnoiditis.  In the Burton report ,  Charles V. Burton, M.D. writes about difference these two stages:

 “The difference between arachnoiditis and adhesive arachnoiditis is the same as that between a candle and a conflagration.”

They are both fire but other  similes exist.  They differ in degree and intensity and the difference is quite substantial.   A candlelit dinner represents fire as a friend.  A conflagration represents fire as a foe.

Adhesive arachnoiditis is the end of the arachnoiditis spectrum.  Adhesive arachnoiditis can carry the possibility of a lifetime of agony while arachnoiditis typically does not.

The cruel nature of adhesive arachnoiditis makes preventing it the most important issue. The early diagnosis and the treatment of the acute stage is important to prevent further damage and save patients from the life long suffering. The fast and early diagnosis is needed to do within the 3 months time window, as soon the better. “Eventually, the nerve roots undergo an inflammatory stage in the affected areas and after three months, they begin to adhere to each other and to the inner layer of the arachnoid initiating the adhesive phase of arachnoiditis

There is two main points in the acute treatment:
1. to calm down inflammation and…
2. to treat pain and other symptoms.
All further invasive spinal operations should be avoided. Prof. Antonio Aldrete has published an article about this issue in the Acta Anaesthesiologica Scandinavica , Neurologic deficits and arachnoiditis following neuroaxial anesthesia. The abstract tells to us:

” Of late, regional anesthesia has enjoyed unprecedented popularity; this increase in cases has brought a higher frequency of instances of neurological deficit and arachnoiditis that may appear as transient nerve root irritation, cauda equina, and conus medullaris syndromes, and later as radiculitis, clumped nerve roots, fibrosis, scarring dural sac deformities, pachymeningitis, pseudomeningocele, and syringomyelia, etc., all associated with arachnoiditis. Arachnoiditis may be caused by infections, myelograms (mostly from oil-based dyes), blood in the intrathecal space, neuroirritant, neurotoxic and/or neurolytic substances, surgical interventions in the spine, intrathecal corticosteroids, and trauma.

Regarding regional anesthesia in the neuroaxis, arachnoiditis has resulted from epidural abscesses, traumatic punctures (blood), local anesthetics, detergents, antiseptics or other substances unintentionally injected into the spinal canal.

Direct trauma to nerve roots or the spinal cord may be manifested as paraesthesia that has not been considered an injurious event; however, it usually implies dural penetration, as there are no nerve roots in the epidural space posteriorly. Sudden severe headache while or shortly after an epidural block using the loss of resistance to air approach usually suggests pneumocephalus from an intradural injection of air. Burning severe pain in the lower back and lower extremities, dysesthesia and numbness not following the usual dermatome distribution, along with bladder, bowel and/or sexual dysfunction, are the most common symptoms of direct trauma to the spinal cord. Such patients should be subjected to a neurological examination followed by an MRI of the effected area. Further spinal procedures are best avoided and the prompt administration of IV corticosteroids and NSAIDs need to be considered in the hope of preventing the inflammatory response from evolving into the proliferative phase of arachnoiditis. “

Prof. Antonio Aldrete has published results of his treatment trials: Aldrete JA, Ghaly RF  2008: Timing of Early Treatment of Neurological Deficits Post Intervention and Operative Spinal Procedures  Commonly the treatment is individual for every patient.