{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T23:48:49Z","timestamp":1790380129764,"version":"4.1.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke"},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["ZIANS003050-17"],"award-info":[{"award-number":["ZIANS003050-17"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"United States Government"},{"DOI":"10.13039\/100000016","name":"U.S. Department of Health and Human Services","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000016","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Arachnoiditis develops from inflammatory processes in the intrathecal space and can cause syringomyelia, myelopathy, radiculopathy, and chronic pain. Understanding inflammatory and fibrotic mechanisms may identify therapeutic targets. We performed a retrospective study of 60 adults who had undergone surgery for arachnoiditis-associated syringomyelia. Clinical status was assessed preoperatively and at 3 to 4\u2009months post-surgery. Cerebrospinal fluid (CSF) was obtained preoperatively, 1-week post-operatively, and at 3 to 4\u2009months. Operative arachnoid adhesion specimens underwent histopathologic review and immunofluorescence staining with quantitative assessment of fibrosis, inflammation, and human endogenous retrovirus group K (HERV-K) antigens. Lesions had mid-thoracic predominance and heterogeneous etiologies. Median CSF white cell counts were low preoperatively (1 cell\/\u00b5L, range: 0 to 11 cells\/\u00b5L). Tissue profiling supported a fibroblast-associated, scar-forming lesion (mean density of CRABP2\u2009=\u2009434 cells\/mm2, ER-TR7\u2009=\u2009430 cells\/mm2) with moderate collagen I deposition (8.1% of specimens), less adaptive immune signals (9 to 180 cells\/mm2), and minimal HERV-K staining (1.1% of tissue). In arachnoiditis-associated syringomyelia, preoperative CSF had few white blood cells; 1-week postoperative CSF had RBC and WBC counts consistent with postoperative meningeal irritation. Chronic fibrosis characterized arachnoid tissue removed at surgery. Histology and immunohistochemical staining suggested that arachnoiditis manifested as a fibroproliferative, adhesive phenotype within the subarachnoid space.<\/jats:p>","DOI":"10.1093\/jnen\/nlag094","type":"journal-article","created":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T12:04:43Z","timestamp":1785585883000},"source":"Crossref","is-referenced-by-count":1,"title":["Clinicopathologic features of spinal arachnoiditis in patients with surgically treated syringomyelia: A retrospective study of 60 cases"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2408-138X","authenticated-orcid":false,"given":"Joseph Y","family":"Choi","sequence":"first","affiliation":[{"name":"Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health , Bethesda, MD,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shantelle A","family":"Graff","sequence":"additional","affiliation":[{"name":"Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health , Bethesda, MD,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hasita V","family":"Nalluri","sequence":"additional","affiliation":[{"name":"Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health , Bethesda, MD,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha M","family":"Quezado","sequence":"additional","affiliation":[{"name":"Center for Cancer Research, National Cancer Institute, National Institutes of Health , Bethesda, MD,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pinar E","family":"Zerk","sequence":"additional","affiliation":[{"name":"Center for Cancer Research, National Cancer Institute, National Institutes of Health , Bethesda, MD,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dragan","family":"Maric","sequence":"additional","affiliation":[{"name":"The Flow & Imaging Cytometry Core Facility, National Institute of Neurological Disorders and Stroke, National Institutes of Health , Bethesda, MD,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorian B","family":"McGavern","sequence":"additional","affiliation":[{"name":"Viral Immunology and Intravital Imaging Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health , Bethesda, MD,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3890-0165","authenticated-orcid":false,"given":"John D","family":"Heiss","sequence":"additional","affiliation":[{"name":"Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, 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