Hida Kazutoshi, Iwasaki Yoshinobu, Ushikoshi Satoshi, Fujimoto Shin, Seki Toshitaka, Miyasaka Kazuo
Department of Neurosurgery, University of Hokkaido Graduate School of Medicine, Sapporo, Japan.
J Neurosurg. 2002 Mar;96(2 Suppl):157-61. doi: 10.3171/spi.2002.96.2.0157.
In this report, the authors describe five consecutive patients with cervical perimedullary arteriovenous fistulas (AVFs) that were successfully treated using a corpectomy performed via an anterior approach.
Five patients with cervical perimedullary AVF underwent corpectomy via an anterior approach. There were four women and one man who ranged in age from 34 to 62 years (median 55 years). Four patients presented with subarachnoid hemorrhage and one with intramedullary hemorrhage. All five AVFs were located on the anterior surface of the cervical spinal cord and fed by the anterior spinal artery. All patients underwent an anterior approach with 1.5- or two-level corpectomy, opening of the dura mater, and coagulation of the fistula. After dural closure, an iliac bone graft was inserted. Four patients were treated by surgery alone and one patient by embolization and surgery. Postoperative angiography revealed complete disappearance of the AVF in all patients. Neurological status improved in two cases and stabilized in the other three. There were no surgery-related complications.
Safe and effective interruption of cervical AVFs can be accomplished by an anterior-approach corpectomy.
在本报告中，作者描述了连续5例经前路椎体次全切除术成功治疗的颈髓周动静脉瘘（AVF）患者。
5例颈髓周AVF患者接受了前路椎体次全切除术。其中4例女性，1例男性，年龄范围为34至62岁（中位年龄55岁）。4例患者表现为蛛网膜下腔出血，1例为髓内出血。所有5例AVF均位于颈髓前表面，由脊髓前动脉供血。所有患者均接受了前路1.5或两个节段的椎体次全切除术、硬脑膜切开及瘘口凝固术。硬脑膜闭合后，植入髂骨块。4例患者仅接受手术治疗，1例患者接受了栓塞和手术治疗。术后血管造影显示所有患者的AVF完全消失。2例患者神经功能改善，另外3例稳定。无手术相关并发症。
前路椎体次全切除术可安全有效地阻断颈AVF。
