The management of spinal dural fistulas: a 13-year retrospective analysis.

INTRODUCTION

Spinal Dural Fistulas (SDAVF) are the most common Spinal Vascular Malformation. The management of SDAVFs has revolved around embolization or surgical interruption. The management strategy employed at this centre is to attempt embolization as first line therapy and to opt for surgery in the event of failure.

METHOD

This retrospective study looks at the management of 38 patients treated for SDAVFs at a tertiary centre over a 13-year period (1997-2010). Patient demographics, procedure and follow-up over a 6-12 month period (mean of approximately 10 months) were analyzed and qualitative assessment of patient outcome was assessed.

RESULTS

Patient ages ranged from 20 to 86 (mean 63.5), with 27 male and 11 female patients. Patients managed since 1995 with a combination of embolization and surgery report either improved symptoms or a return to normal were 73.7%. Micturition and bowel symptoms indicated more severe disability and were more likely to contribute to no improvement in overall outcome.

CONCLUSIONS

This centre has in place a management strategy for SDAVF that contributes to both radiologically and symptomatically successful treatment.