Department of Radiology, Niigata University Medical and Dental Hospital, Asahimachi-dori 1-757, Chuo-ku, Niigata, 951-8510, Japan.
Jpn J Radiol. 2013 Jul;31(7):455-64. doi: 10.1007/s11604-013-0216-6. Epub 2013 May 31.
We retrospectively evaluated the clinical outcome after multidisciplinary treatment of spinal arteriovenous fistulas (AVFs) in terms of the Aminoff-Logue grading scale (ALS) to depict the outcome in a perspective pertinent to the quality of everyday living.
Twenty-six spinal AVFs in 25 patients were angiographically diagnosed from April 1998 through April 2012 and treated by endovascular embolization or surgery. When both treatment procedures seemed feasible, embolization was undertaken as the initial treatment. Motor and gait disturbance at follow-up was retrospectively graded according to ALS.
All lesions were localized at the thoracolumbar or sacral levels and include six epidural AVFs with intradural venous reflux, 14 dural AVFs, and six perimedullary AVFs. Embolization was performed as the initial treatment for 17 lesions, while open surgery was performed for the others as well as for residual or recurrent lesions after embolization. All lesions were completely occluded except three perimedullary AVFs. At clinical follow-up of 1-153 months (mean 53.3), amelioration of gait disturbance with reduction of ALS scores was noted for 13 lesions and amelioration of micturition for 13 lesions as well.
Clinical functional status was improved for half of the lesions after the multidisciplinary treatment.
我们通过 Aminoff-Logue 分级量表（ALS）回顾性评估了脊髓动静脉瘘（AVF）的多学科治疗后的临床结果，以描绘与日常生活质量相关的结果。
1998 年 4 月至 2012 年 4 月，25 例患者的 26 个脊髓 AVF 通过血管造影诊断，并通过血管内栓塞或手术治疗。当两种治疗方法都可行时，栓塞作为初始治疗。根据 ALS 对随访时的运动和步态障碍进行回顾性分级。
所有病变均位于胸腰椎或骶尾部，包括 6 个硬膜外 AVF 伴硬膜内静脉反流、14 个硬脊膜 AVF 和 6 个脊髓旁 AVF。17 个病变行栓塞治疗作为初始治疗，其余病变及栓塞后残留或复发病变行开放手术治疗。除 3 个脊髓旁 AVF 外，所有病变均完全闭塞。在 1-153 个月（平均 53.3 个月）的临床随访中，13 个病变的步态障碍改善，ALS 评分降低，13 个病变的排尿改善。
经过多学科治疗，一半的病变的临床功能状态得到了改善。
