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腰椎神经根阻滞术后导致急性截瘫的脊髓动静脉瘘:成功栓塞并实现神经功能完全恢复——病例报告

Spinal arteriovenous fistula leading to acute paraplegia after a lumbar nerve root block: Successful embolization with complete neurological recovery-a case report.

作者信息

Gonzalez-Morgado Diego, de Dios-Lascuevas Marta, Blasco-Casado Ferran, Segura-Navarro Xurxo, Tomasello-Weitz Alejandro, Piñana Carlos, Haddad Sleiman

机构信息

Orthopedic Surgery Department, Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain.

Interventional Neuroradiology Unit, Radiology Department, Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain.

出版信息

Interv Neuroradiol. 2024 Aug 28:15910199241276578. doi: 10.1177/15910199241276578.

Abstract

Spinal arteriovenous fistulas (SAVFs) are the most common type of vascular malformation of the spine in adult patients. They can lead to acute or progressive myelopathy due to venous congestion of the medullary veins. While most SAVFs are acquired, their pathophysiology remains unclear. The natural history of the disease and its clinical presentation are highly influenced by the location of the fistula and various factors may trigger sudden neurological decline. We present a case of a patient who developed a complete spinal cord injury after a lumbar nerve root block, likely due to an undiagnosed SAVF. The patient underwent endovascular embolization, resulting in a complete recovery of neurological function.

摘要

脊髓动静脉瘘(SAVF)是成年患者中最常见的脊柱血管畸形类型。由于髓静脉淤血,它们可导致急性或进行性脊髓病。虽然大多数SAVF是后天获得的,但其病理生理学仍不清楚。疾病的自然史及其临床表现受瘘管位置的高度影响,各种因素可能引发突然的神经功能衰退。我们报告一例患者,在进行腰神经根阻滞术后发生完全性脊髓损伤,可能是由于未被诊断出的SAVF所致。该患者接受了血管内栓塞治疗,神经功能完全恢复。

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本文引用的文献

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Percutaneous Embolization of Spinal Epidural Arteriovenous Fistulae: Report of 2 Cases and Technical Considerations.
J Vasc Interv Radiol. 2023 Mar;34(3):498-500.e3. doi: 10.1016/j.jvir.2022.11.027. Epub 2022 Dec 5.
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