Ouyang Yang, Qu Yang, Dong Rong-Peng, Kang Ming-Yang, Yu Tong, Cheng Xue-Liang, Zhao Jian-Wu
Department of Orthopaedics, The Second Hospital of Jilin University, Changchun 130041, Jilin Province, China.
World J Clin Cases. 2021 Jul 16;9(20):5594-5604. doi: 10.12998/wjcc.v9.i20.5594.
Spinal dural arteriovenous fistula (SDAVF) is an extremely rare vascular malformation of the central nervous system that is often confused with degenerative spinal disorders due to similar early symptoms and clinical features. Here, we report a case of SDAVF recurrence 8 years after lumbar spine surgery and summarize relevant literature.
A 54-year-old male was admitted to our hospital complaining of lower back pain, numbness in both lower extremities and intermittent claudication. Subsequent imaging identified lumbar spinal stenosis. Following surgical treatment, the patient's symptoms significantly resolved, and he was able to perform daily activities. However, similar symptoms appeared 8 years later, followed by confirmation of SDAVF diagnosis. The patient underwent neurosurgery 7 mo after symptom onset. The follow-up period lasted 14 mo, and the patient remains with marginal neurological symptoms.
This case highlights the importance of prompt SDAVF diagnosis. Due to its nonspecific clinical presentation, the clinical experience of the surgeon and definitive imaging examination are indispensable. Additionally, timely neurosurgery is effective and may significantly improve patient outcomes.
脊髓硬脊膜动静脉瘘（SDAVF）是一种极为罕见的中枢神经系统血管畸形，因其早期症状和临床特征相似，常与退行性脊柱疾病相混淆。在此，我们报告一例腰椎手术后8年发生SDAVF复发的病例，并总结相关文献。
一名54岁男性因下背部疼痛、双下肢麻木和间歇性跛行入院。随后的影像学检查发现腰椎管狭窄。手术治疗后，患者症状明显缓解，能够进行日常活动。然而，8年后出现了类似症状，随后确诊为SDAVF。患者在症状出现7个月后接受了神经外科手术。随访期为14个月，患者仍有轻微神经症状。
该病例凸显了及时诊断SDAVF的重要性。由于其临床表现不具特异性，外科医生的临床经验和确定性影像学检查不可或缺。此外，及时进行神经外科手术是有效的，可能会显著改善患者的预后。
