Spinal adhesive arachnoiditis in an adult patient with spinal muscular atrophy type 3 treated with intrathecal therapy

Spinal adhesive arachnoiditis (SAA) is an inflammatory process affecting the arachnoid membrane, which surrounds nerve roots in the spine. This inflammation can be caused by infections, spinal cord injuries, surgeries, or the administration of substances directly into the spinal fluid. This case report describes a woman with spinal muscular atrophy (SMA) who developed severe back pain and was subsequently diagnosed with SAA after receiving nusinersen, a medication administered intrathecally (into the spinal fluid) for SMA treatment. The authors suggest that regular MRI scans of the lower spine could be beneficial for monitoring patients undergoing intrathecal therapy for spinal muscular atrophy, as it may help in the early detection of SAA.

• 1
  A 56-year-old woman with SMA type 3 developed SAA after treatment with intrathecal nusinersen.
• 2
  MRI findings revealed distorted nerve roots adherent to the thecal sac, a characteristic sign of SAA.
• 3
  The patient's symptoms improved slightly with high-dose methylprednisolone, non-steroidal anti-inflammatory drugs, and rehabilitation.