Will Social Security Consider Arachnoiditis Disabling?

Spinal arachnoiditis is the third most common cause of failed back surgery syndrome, after stenosis and recurrent disc problem. Social Security will find it disabling if the medical records establish the following criteria:

"Spinal arachnoiditis, confirmed by an operative note or pathology report of tissue biopsy, or by appropriate medically acceptable imaging, manifested by severe burning or painful dysesthesia, resulting in the need for changes in position or posture more than once every 2 hours."

Often the medical records will establish the presence of epidural fibrosis, adhesions or scar tissue rather than actually documenting arachnoiditis.

Arachnoiditis is chronic inflammation inside the dura, in the arachnoid layer of the meninges whereas epidural (also called peridural, extradural) fibrosis is scarrign outside the dural sac.  This latter may also be referred to as "adhesions" or "scar tissue."  Many doctors appear to regard epidural fibrosis as less clinically significant than arachnoiditis, but in essence the nerve root compression arising from epidural fibrosis may cause similar clinical problems in terms of lower limb pain, sensory disturbance and weakness.  Epidural fibrosis differs from arachnoidtitis in that it is more likely to be a localized problem-affecting just one or two nerve roots-and is generally a post-surgical phenomenon, although it may also be a sequel to invasive procedures such as chemonycleolysis.

These terms can be substituted to equal 1.04B when the resulting functional limitation is analogous.  This is confirmed in SSA 2002 Training Materials on the Revised Musculoskeletal Listings.