Abecassis Isaac Josh, Osbun Joshua W, Kim Louis
Department of Neurological Surgery, University of Washington, Seattle, WA, USA.
Department of Neurosurgery, Emory University, Atlanta, GA, USA.
Handb Clin Neurol. 2017;143:135-143. doi: 10.1016/B978-0-444-63640-9.00013-8.
Spinal arteriovenous malformations and fistulas comprise spinal vascular malformations (sVMs), a rare but challenging neurosurgic entity. A number of mechanisms have been proposed as explanations of neurologic decline in the setting of arteriovenous shunting, including venous hypertension, venous congestion, hemorrhage, vascular steal, or mass effect, which can be worsened with venous varices or aneurysmal dilations. Anatomic location and features dictate the categorization of sVMs. Two major systems are in place for classification of sVMs - (1) the American/French/English connection and (2) the Spetzler system - as well as a number of systems that have been described over the past century.
脊髓动静脉畸形和瘘管属于脊髓血管畸形（sVMs），这是一种罕见但具有挑战性的神经外科疾病。已经提出了多种机制来解释动静脉分流情况下的神经功能衰退，包括静脉高压、静脉淤血、出血、盗血或占位效应，而静脉曲张或动脉瘤样扩张会使这些情况恶化。解剖位置和特征决定了sVMs的分类。目前有两种主要的sVMs分类系统——（1）美国/法国/英国联合分类法和（2）斯佩茨勒系统——以及过去一个世纪中描述的许多其他系统。
