Diagnosis and treatment of spinal dural arteriovenous fistulas: 110 cases report.
- Author:
Meng LI
1
;
Hong-qi ZHANG
;
Xing-long ZHI
;
Ge CHEN
;
Yong-zhi SHAN
;
Wen-jin CHEN
;
Hao WU
;
Feng LING
Author Information
- Publication Type:Journal Article
- MeSH: Adult; Aged; Central Nervous System Vascular Malformations; diagnosis; therapy; Drainage; Dura Mater; blood supply; Embolization, Therapeutic; methods; Female; Humans; Laminectomy; methods; Magnetic Resonance Angiography; Male; Middle Aged; Retrospective Studies; Spinal Cord; blood supply
- From: Chinese Journal of Surgery 2003;41(2):99-102
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo discuss the diagnosis, treatment and prognosis of spinal dural arteriovenous fistulas (SDAVF).
METHODSThe clinical and following-up date from 110 patients with SDAVF diagnosed by spinal MRI and spinal angiography were analyzed retrospectively.
RESULTSDraining vein between fistula and spinal cord was interrupted by laminectomy approach as first choice in 61 patients, by hemi-laminectomy approach in 37, and by endovascular embolization in 12, and re-operation due to recurrence after embolization in 3. Anticoagulation, hydration and early rehabilitation were used postoperatively. Complete disappearance of SDAVF was confirmed in all 106 patients who received postoperative spinal angiography. The para-medullary tortuous flow voids fully disappeared in 74 patients and partly disappeared in 15 on postoperative T(2)-weighted MRI. Follow up of 98 patients showed complete recovery in 54 patients, improvement in 34, and no change in 10. Three of the 10 patients were reoperated on because of recurrence 1 to 5 years after embolization.
CONCLUSIONSSDAVF can produce good outcome after early diagnosis and treatment. Interruption of the draining vein between fistula and spinal cord by hemi-laminectomy approach is the first choice for the treatment of SDAVF.
