Surgical treatment of thoracic arachnoiditis with multiple subarachnoid cysts caused by epidural anesthesia

We report on a 36 year-old woman who had sensorimotor and sphincter dysfunction 0.5 day after having an epidural anesthesia to deliver her baby. The patientsʹ neurological deficits recovered gradually and she could walk without support 1.5 months after the operation. However, her neurological function deteriorated 4 months after anesthesia and a magnetic resonance imaging (MRI) study revealed spinal arachnoiditis with multiple subarachnoid cysts at the T5-7 levels. Surgical treatment consisted of lysis of adhesions and wide opening of the subarachnoid cysts. Her motor function improved after operation and she could walk without support after a 1 year follow-up. However, her sphincter and sensory abnormalities persisted for the most part. The literature on the surgical treatment of arachnoiditis with myelopathy is reviewed and the surgical indications are discussed.