Arachnoiditis Ossificans Following Repeat Epidural Steroid Injections: A Case Study

Background: Arachnoiditis ossificans is a rare entity resulting from chronic inflammation, leading to scarring, fibrosis, and, ultimately, calcification. It is usually preceded by trauma, infection, or interventional procedures involving disruption of the dura. When present in the lumbar spine, most patients present with progressive radicular symptoms in the setting of chronic pain. Computed tomography (CT) scan is the diagnostic tool of choice and is often ordered to further assess uncertain magnetic resonance imaging (MRI) findings. There is no gold standard treatment, but most patients ultimately require surgical intervention with mixed success rates. Upon review of the literature, no documented cases of arachnoiditis ossificans occurring in active-duty service members.

Case Presentation: The case presents a 31-year-old male veteran with a history of multiple epidural steroid injections who developed arachnoiditis ossificans in the absence of typical risk factors.

Conclusions: Generally considered a safe alternative to surgery, epidural steroid injections are not without risk of serious long-term complications that should be considered during the treatment of low back pain among veterans.