Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Shizuoka, Japan.
Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Shizuoka, Japan.
World Neurosurg. 2019 Aug;128:50-54. doi: 10.1016/j.wneu.2019.04.202. Epub 2019 May 1.
Formation of a dural arteriovenous fistula (DAVF) after lumbar spine decompression in the lumbar spine has been reported as a late complication, but is extremely rare in the cervical spine.
A 57-year-old man who underwent a C5-6, C6-7 anterior fusion 5 years previously for cervical myelopathy at another hospital presented with progressive gait disturbance and thermal hypoalgesia on the right side of the body. Magnetic resonance imaging showed flow voids in the spinal cord dorsally at the C4-7 level, which had not been detected before the initial operation. Digital subtraction angiography showed a fistulous connection at the C7 level between the perimedullary vein and a segmental artery from the right vertebral artery, which was diagnosed as a DAVF. Surgical interruption of the intradural draining vein with multilevel posterior cervical decompression was performed, and his symptoms improved.
To the best of our knowledge, this is the first report of a DAVF developing after multilevel anterior cervical discectomy and fusion. All the published cases of secondary DAVF, especially after spinal surgery, are reviewed.
腰椎减压术后形成硬脑膜动静脉瘘（DAVF）已被报道为一种迟发性并发症，但在颈椎中极为罕见。
一名 57 岁男性，5 年前因颈椎病在另一家医院行 C5-6、C6-7 前路融合术，现出现进行性步态障碍和右侧体感热觉减退。磁共振成像显示 C4-7 水平脊髓背侧有血流空影，而在初次手术前未检测到。数字减影血管造影显示 C7 水平髓周静脉与来自右侧椎动脉的节段性动脉之间存在瘘管连接，诊断为 DAVF。行多节段后路颈椎减压术，阻断硬脑膜内引流静脉，患者症状改善。
据我们所知，这是首例多节段前路颈椎间盘切除融合术后发生 DAVF 的报告。回顾了所有已发表的继发性 DAVF 病例，特别是脊柱手术后发生的病例。
