Intrathecal hyaluronidase treatment of chronic spinal arachnoiditis of noninfective etiology.

Fifteen cases of spinal arachnoiditis of noninfective etiology were treated with intrathecal hyaluronidase. In 10 patients, no obvious cause was evident; in four patients, arachnoiditis was the result of disk prolapse; and in one it followed spinal surgery. Fifteen hundred international units of hyaluronidase was injected intrathecally at intervals of 7-14 days. Four to nine injections (mean, 5.9) were given to each patient, and the patients were observed for 3-30 months (mean, 9.7). The effect of the treatment was assessed by the change in clinical grading from the pretreatment phase to the last examination. Satisfactory improvement was observed in 11 patients (73.3%) and "mild" recovery was observed in three patients. Because of this therapeutic efficacy and lack of serious toxic effects, intrathecally administered hyaluronidase appears to be of value in the management of spinal arachnoiditis.