KAWAMATA Takakazu    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Professor and Division head
Article types	Case report
Language	English
Peer review	Peer reviewed
Title	Novel surgical management of spinal adhesive arachnoiditis by arachnoid microdissection and ventriculo-subarachnoid shunting.
Journal	Formal name：Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia Abbreviation：J Clin Neurosci ISSN code：1532-2653(Electronic)0967-5868(Linking)
Volume, Issue, Page	18(12),pp.1702-4
Author and coauthor	Mitsuyama Tetsuryu, Asamoto Shunji, Kawamata Takakazu
Authorship	Last author,Corresponding author
Publication date	2011/12
Summary	Spinal cord tethering and cerebrospinal fluid (CSF) flow disturbance are two major features in the pathophysiology of spinal adhesive arachnoiditis. We hypothesized that insufficient CSF supply to the surgically untethered spinal cord may be one of the causes of the typical post-operative recurrent extensive lesion. We report a patient with extensive spinal adhesive arachnoiditis, who was successfully treated using a novel surgical technique consisting of two procedures. First, microdissection of the thickened adherent arachnoid was performed to resolve spinal cord tethering. Next, a ventriculo-subarachnoid shunt was placed to provide sufficient flow of CSF. Clinical improvement was sustained for at least 22 months after surgery. The present surgical procedure may improve clinical outcome in patients with longitudinally extensive spinal adhesive arachnoiditis.
DOI	10.1016/j.jocn.2011.03.014
Document No.	22019435