Treatment strategy of spinal arteriovenous malformations based on a simple classification.

We propose a treatment strategy of the spinal arteriovenous malformation (AVM) based on a simple classification. This classification includes three types: dural arteriovenous fistula (AVF), perimedullary AVF and intramedullary AVM. Dural AVF has its shunt at the dura and can be treated with either surgery or embolization with liquid adhesive. Perimedullary AVF has shunt on the spinal cord surface and it can be subcategorized into types 1-3 depending on the size of vascular pedicles. Types 1 and 2 are treated with surgery, type 3 by balloon or coil embolization. Intramedullary AVM has its nidus in the cord and is difficult to treat either by surgery or endovascular technique.