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脊髓动静脉畸形:手术治疗

Spinal arteriovenous malformations: surgical management.

作者信息

Xu David S, Sun Hai, Spetzler Robert F

机构信息

Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.

Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.

出版信息

Handb Clin Neurol. 2017;143:153-160. doi: 10.1016/B978-0-444-63640-9.00015-1.

Abstract

Spinal arteriovenous malformations (AVMs) are a diverse population of vascular lesions associated with significant long-term morbidity and neurologic impairment. Spinal AVMs can be classified into three categories: intramedullary, extradural-intradural, and conus, depending on their angioarchitecture and anatomy. Extradural-intradural lesions are typically incurable due to their diffuse nature, but patients may benefit from targeted therapy of symptomatic components. Intramedullary and conus AVMs are amenable to safe surgical resection when combined with endovascular embolization and use of a pial dissection technique that spares entry into the neural parenchyma.

摘要

脊髓动静脉畸形(AVM)是一类多样的血管病变,与显著的长期发病率和神经功能损害相关。根据其血管构筑和解剖结构,脊髓AVM可分为三类:髓内型、硬膜外-硬膜内型和圆锥型。硬膜外-硬膜内病变由于其弥漫性通常无法治愈,但患者可能从对症成分的靶向治疗中获益。当结合血管内栓塞和使用避免进入神经实质的软膜分离技术时,髓内和圆锥型AVM适合进行安全的手术切除。

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