Subarachnoid Spinal Adhesions

Abstract

Subarachnoid spinal adhesions may at times produce clinical symptoms. Such a case has been observed by us in which following a laminectomy for paraplegia numerous adhesions of the spinal subarachnoid space were found. These adhesions were divided, but as adhesions involving all serous membranes are apt to recur, the possibility of a recurrence of these subarachnoid adhesions was considered. As Herrmann and Musser, 1 and Ochsner and Herrmann 2 had successfully prevented the recurrence of adhesions in the pericardial cavity and Ochsner and Mason 3 in the peritoneal cavity experimentally by the use of digestants, it was thought possible that such procedures might be employed in the prevention of the recurrence of spinal subarachnoid adhesions.

Our purpose in this study was to produce subarachnoid adhesions by introducing an irritant into the spinal subarachnoid space in the lower thoracic region of dogs, later to divide these adhesions, and to attempt to prevent their reformation by introducing a digestion solution. We have been able to find no record of a previous attempt of this kind, although Dr. E. R. Schmidt, of the University of Wisconsin, has employed a digestant in the subarachnoid space in one case in order to attempt to prevent the reformation of adhesions.

The experimental animals employed were dogs. An attempt was made to inject the irritant into the spinal subarachnoid space by spinal puncture, but because of the difficulty encountered in performing a lumbar puncture, this method was abandoned. A formal laminectomy was employed in the remainder of the animals, and the irritant was injected into the subarachnoid space by means of a syringe and cannula. The animals were prepared in the usual manner; ether was used as the anesthetic agent.