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56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

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Long-term results of microsurgical treatment for spinal dural arteriovenous fistulas

Langzeitergebnisse nach mikrochirurgischer Therapie spinaler duraler arteriovenöser Fisteln

Meeting Abstract

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  • corresponding author M. F. Oertel - Neurochirurgische Klinik, Universitätsklinikum Aachen
  • V. Rohde - Neurochirurgische Klinik, Universitätsklinikum Aachen
  • J. M. Gilsbach - Neurochirurgische Klinik, Universitätsklinikum Aachen

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc11.05.-09.04

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2005/05dgnc0214.shtml

Published: May 4, 2005

© 2005 Oertel et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective

Although rare, spinal dural arteriovenous fistulas (SDAVF) are the most common type of vascular malformations involving the spinal cord. However, limited follow-up data exist to determine long-term clinical outcome after treatment for SDAVF. Based on the analysis of the longest follow-up interval reported so far, the aim of the current study was to determine the short- and long-term results of patients treated by microsurgical obliteration for SDAVF.

Methods

The data of 61 consecutive patients (47 males, 14 females) with angiographically confirmed and microsurgically treated SDAVF between 1990 and 1999 could be retrospectively evaluated. The mean age was 60 years (range 32 to 79 years). 40/61 patients were available for long-term follow-up. The follow-up period was at minimum 5 years (range 5 to 14 years). Functional status was measured by use of the Aminoff-Logue score.

Results

3/61 lesions were located in the cervical/foramen magnum area, 42/61 in the thoracic, 16/61 in the lumbar, and 2/61 in the sacral spine. In the 61 patients, surgical-associated complications were minor and rare (3 wound healing disturbances, 1 subcutaneous accumulation of CSF, 1 spinal epidural haematoma). 3 patients had to be operated on because of a residual (1/61) or second SDAVF (2/61). Early postoperatively, 47/61 patients improved following surgery. The symptomatology of 14/61 patients remained unchanged. 34/40 of the patients available for long-term follow-up improved (27/38) or stabilized (7/40), 6/40 patients´ symptomatology increased after surgery.

Conclusions

Microsurgical obliteration represents an adequate and minimally invasive surgical technique for the treatment of SDAVF, which offers safe, immediate and definitive occlusion of SDAVF with good long-term results. However, even if the SDAVF are successfully occluded, some patients recover incomplete or deteriorate neurologically after initial improvement during the long-term interval, which might be caused by atrophy with loss of tissue mass because of irreversible demyelination and progressive gliotic changes of the spinal cord.