Vázquez Enrique J, Gefaell Joaquín, Fernandez Leticia, López Eva, Areitio Eduardo, Elexpuru Jose A
Department of Neurosurgery, Hospital Universitario Basurto, Avenida de Montevideo 18, 48013, Bilbao, Biscay, Spain.
Department of Neurosurgery, Clínica IMQ Zorrotzaurre, Bilbao, Biscay, Spain.
Acta Neurochir (Wien). 2017 Jun;159(6):1107-1111. doi: 10.1007/s00701-017-3150-z. Epub 2017 Apr 4.
Spinal extradural arteriovenous fistulas (SEDAVF) with intradural drainage are uncommon vascular lesions that cause venous congestive myelopathy. We present three SEDAVF with intradural drainage treated with surgical disconnection of the intradural drainage via a single level laminectomy, followed by transarterial embolization (TAE) with Onyx if spontaneous thrombosis of the extradural fistula did not occur spontaneously. All patients improved their neurological condition and no congestive myelopathy recurrence was noted after mean follow-up of 84 months. We believe that SEDAVF with intradural drainage constitute a specific entity that should be included in the classifications of spinal arteriovenous malformations.
伴有硬膜内引流的脊髓硬膜外动静脉瘘(SEDAVF)是一种罕见的血管病变,可导致静脉性充血性脊髓病。我们报告了3例伴有硬膜内引流的SEDAVF,通过单节段椎板切除术对硬膜内引流进行手术切断治疗,若硬膜外瘘未自发形成血栓,则随后使用Onyx进行经动脉栓塞(TAE)。所有患者的神经状况均有改善,平均随访84个月后未发现充血性脊髓病复发。我们认为,伴有硬膜内引流的SEDAVF构成一种特殊类型,应纳入脊髓动静脉畸形的分类中。