ADHESIVE ARACHNOIDITIS: A RARE AND UNDERDIAGNOSED COMPLICATION OF NEURAXIAL BLOCKS

Abstract

This article aimed to discuss adhesive arachnoiditis as a rare and underdiagnosed complication associated with neuraxial blockade procedures, such as spinal anesthesia and epidural anesthesia, highlighting its disabling potential resulting from the inflammatory process affecting the arachnoid membrane, with subsequent fibrous tissue formation and adhesions that may lead to severe and irreversible neurological deficits. The study aimed to identify the main aspects related to the pathophysiology, clinical manifestations, diagnosis, and therapeutic management of the disease through a literature review. To this end, a bibliographic search was conducted in the PubMed and Virtual Health Library (VHL) databases, complemented by a manual search in Google Scholar, using the descriptors "Adhesive Arachnoiditis," "Spinal Anesthesia," and "Anesthesia," combined with the Boolean operators AND and OR. A total of 11 articles published over the last ten years were selected for analysis. The findings demonstrated that adhesive arachnoiditis remains a condition with challenging diagnosis and management, reinforcing the need for careful monitoring during neuraxial blockade procedures and for the early recognition of clinical manifestations associated with this complication. It is concluded that the timely identification of the inflammatory process may help reduce disease progression and minimize the risk of permanent neurological deficits.