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http://www.burtonreport.com/PDF_Files/ArachSurveyNZ.PDF
"Adhesive arachnoiditis" seems to be a common diagnosis that Dr Tennant uses for his patients from all around the country that require INSANE levels of narcotic medications and become "disabled" as a result. I have never really come across this diagnosis among literally 1000s of patients I have seen and neither have anyone in my fellowship program or large groups I have worked with.
Due to this diagnosis being so esoteric, I have done a literature search out of New Zeeland, where the topic was hyped to the max by guys like this fraudster Dr Tennant who use it to justify insane levels of narcotic medications and "disability" for patients who are "permanently" unable to work.
Mind you that patient "advocate" groups about arachnoiditis have tried to blame LESIs for this disease among many other causes such as myelography, failed back surgeries, etc.
Critical points of reference include:
"Attempts to correlate clinical signs and symptoms with radiological findings of arachnoiditis have produced variable results. The origin, type, location and distribution of symptoms in arachnoiditis patients are atypical and present a complex clinical picture."
"Myelograms, surgery or trauma is clinically significant nor that it progresses to arachnoiditis. Although all degrees of inflammation could be termed arachnoiditis, the term reserved for more clinically obvious and symptomatic forms is usually chronic adhesive arachnoiditis. Advanced and severe inflammatory forms of arachnoiditis have been identified in case reports. Though documented, they are forms rarely seen precluded by diagnosis of the precipitating disease. Opinion is varied over whether or not these are forms of the same disease or distinct entities"
"Summary: Radiology has provided objective evidence of arachnoiditis. The development of radiological diagnostic technologies have allowed for greater anatomical detail of the spinal meninges and surrounding structures to become available. MRI has become the diagnostic test of choice with its noninvasiveness and the greater degree of anatomical detail it provides. But the relationship between abnormalities and low back pain is controversial as asymptomatic patients have been shown to have abnormalities. The literature contains varied descriptions of the “clinical syndrome” of arachnoiditis. There is no “typical” clinical pattern in patients. Arachnoiditis presents as a complex clinical picture given the varied origin, type, location and distribution of symptoms. Chronic severe back and/or lower leg pain is the most common presenting symptom. The clinical history of most patients includes presentation for back injury and back/leg pain and prior multiple myelograms and back surgeries. Some patients may not improve and are diagnosed with a class of “failed back” syndromes. Arachnoiditis is not well described in medical text books, disease classification and diagnostic taxonomy systems. Other existing spinal pathologies may also overlap with arachnoiditis. The exact relationship between the radiological and pathological entities of arachnoiditis and the clinical syndrome remains to be clearly demonstrated."
How does Tennant convincingly show that his patients have this severe form of arachnoiditis considering the medical literature can't even define exactly what it is, the prognosis, the etiology, if its a distinct entity rather and the clinical findings outside of "pain".
Also most people with "arachnoiditis" have only minor inflammation that resolved overtime. Rarely is there any radiological confirmation of this diagnosis in case reports.
Prevalence appears very rare but is unknown.
Does anyone have any other ideas on this diagnosis and how to objectively determine its prevalence, prognosis, etc?
"Adhesive arachnoiditis" seems to be a common diagnosis that Dr Tennant uses for his patients from all around the country that require INSANE levels of narcotic medications and become "disabled" as a result. I have never really come across this diagnosis among literally 1000s of patients I have seen and neither have anyone in my fellowship program or large groups I have worked with.
Due to this diagnosis being so esoteric, I have done a literature search out of New Zeeland, where the topic was hyped to the max by guys like this fraudster Dr Tennant who use it to justify insane levels of narcotic medications and "disability" for patients who are "permanently" unable to work.
Mind you that patient "advocate" groups about arachnoiditis have tried to blame LESIs for this disease among many other causes such as myelography, failed back surgeries, etc.
Critical points of reference include:
"Attempts to correlate clinical signs and symptoms with radiological findings of arachnoiditis have produced variable results. The origin, type, location and distribution of symptoms in arachnoiditis patients are atypical and present a complex clinical picture."
"Myelograms, surgery or trauma is clinically significant nor that it progresses to arachnoiditis. Although all degrees of inflammation could be termed arachnoiditis, the term reserved for more clinically obvious and symptomatic forms is usually chronic adhesive arachnoiditis. Advanced and severe inflammatory forms of arachnoiditis have been identified in case reports. Though documented, they are forms rarely seen precluded by diagnosis of the precipitating disease. Opinion is varied over whether or not these are forms of the same disease or distinct entities"
"Summary: Radiology has provided objective evidence of arachnoiditis. The development of radiological diagnostic technologies have allowed for greater anatomical detail of the spinal meninges and surrounding structures to become available. MRI has become the diagnostic test of choice with its noninvasiveness and the greater degree of anatomical detail it provides. But the relationship between abnormalities and low back pain is controversial as asymptomatic patients have been shown to have abnormalities. The literature contains varied descriptions of the “clinical syndrome” of arachnoiditis. There is no “typical” clinical pattern in patients. Arachnoiditis presents as a complex clinical picture given the varied origin, type, location and distribution of symptoms. Chronic severe back and/or lower leg pain is the most common presenting symptom. The clinical history of most patients includes presentation for back injury and back/leg pain and prior multiple myelograms and back surgeries. Some patients may not improve and are diagnosed with a class of “failed back” syndromes. Arachnoiditis is not well described in medical text books, disease classification and diagnostic taxonomy systems. Other existing spinal pathologies may also overlap with arachnoiditis. The exact relationship between the radiological and pathological entities of arachnoiditis and the clinical syndrome remains to be clearly demonstrated."
How does Tennant convincingly show that his patients have this severe form of arachnoiditis considering the medical literature can't even define exactly what it is, the prognosis, the etiology, if its a distinct entity rather and the clinical findings outside of "pain".
Also most people with "arachnoiditis" have only minor inflammation that resolved overtime. Rarely is there any radiological confirmation of this diagnosis in case reports.
Prevalence appears very rare but is unknown.
Does anyone have any other ideas on this diagnosis and how to objectively determine its prevalence, prognosis, etc?
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