Babichev K N, Orlov V P, Stanishevskiy A V, Savello A V, Svistov D V
Military medical Academy named after S. M. Kirov, Saint-Petersburg, Russia.
Zh Vopr Neirokhir Im N N Burdenko. 2017;81(4):33-44. doi: 10.17116/neiro201781433-42.
Spinal dural arteriovenous fistulas (SDAVFs) are the most common vascular malformation of the spinal cord, causing segmental lesions of the spinal cord due to venous ischemia. Functional outcomes of treatment in SDAVF patients are favorable, but the rate of improvement varies from 25 to 100%, which complicates prediction of the treatment outcome.
the study aim was to identify a relationship between fistula localization and clinical manifestations and evaluate the effect of disease duration and severity of neurological impairments on immediate and long-term treatment outcomes, based on analysis of the literature and own data.
In September 2016, we performed a PubMed search for publications using keywords 'spinal arteriovenous fistula', 'treatment', and 'outcome'. We selected publications containing information on the patient's age, fistula location, disease duration, and evaluation of symptom severity (Aminoff-Logue scale) preoperatively, postoperatively, and at least 3 months after surgery. The analysis also included data on patients operated on at the clinic. A total of 187 patients were included in the analysis.
The fistula was most often located at the T6, T7, and T9 level, with motor disorders being more severe for fistulas located at or below the T9 vertebra. Surgical isolation of the fistula improved the functional state of patients, with patients under the age of 60 years having a better prognosis for recovery of impaired functions. Motor disorders significantly regressed in the early postoperative period in all patients, but in the long-term period, there was worsening of motor disorders in patients with a better baseline functional state.
脊髓硬脊膜动静脉瘘（SDAVF）是脊髓最常见的血管畸形，由于静脉缺血导致脊髓节段性病变。SDAVF患者治疗的功能预后良好，但改善率在25%至100%之间变化，这使得治疗结果的预测变得复杂。
本研究旨在基于文献分析和自身数据，确定瘘管定位与临床表现之间的关系，并评估疾病持续时间和神经功能障碍严重程度对近期和长期治疗结果的影响。
2016年9月，我们在PubMed上搜索了使用关键词“脊髓动静脉瘘”、“治疗”和“结果”的出版物。我们选择了包含患者年龄、瘘管位置、疾病持续时间以及术前、术后和术后至少3个月症状严重程度评估（阿明诺夫-洛格量表）信息的出版物。分析还包括在该诊所接受手术的患者的数据。共有187例患者纳入分析。
瘘管最常位于T6、T7和T9水平，位于T9椎体及以下的瘘管运动障碍更严重。瘘管的手术隔离改善了患者的功能状态，60岁以下患者功能受损恢复的预后更好。所有患者术后早期运动障碍均显著改善，但长期来看，基线功能状态较好的患者运动障碍有所恶化。
