gms | German Medical Science

57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

Microsurgical obliteration of type I spinal AVM

Mikrochirurgische Obliteration spinaler Typ I AVM

Meeting Abstract

  • corresponding author M.F. Oertel - Neurochirurgische Klinik, Universitätsklinikum der RWTH Aachen
  • V. Rohde - Neurochirurgische Klinik, Universitätsklinikum der RWTH Aachen
  • F.J. Hans - Neurochirurgische Klinik, Universitätsklinikum der RWTH Aachen
  • M. Mull - Abteilung für Neuroradiologie, Universitätsklinikum der RWTH Aachen
  • A. Thron - Abteilung für Neuroradiologie, Universitätsklinikum der RWTH Aachen
  • J.M. Gilsbach - Neurochirurgische Klinik, Universitätsklinikum der RWTH Aachen

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocSA.05.01

The electronic version of this article is the complete one and can be found online at:

Published: May 8, 2006

© 2006 Oertel et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Treatment options for spinal dural arteriovenous fistulae (Type I spinal AVM) include microsurgical obliteration, endovascular embolization and a combined interdisciplinary approach. A 10-year single-institution retrospective review of experience with operative management of Type I spinal AVM is presented in order to evaluate treatment efficiency, functional patient outcome and prognosis following surgery.

Methods: The data of 75 consecutive patients (57 males, 18 females) with microsurgically treated Type I spinal AVM between 1990 and 2000 was analyzed in retrospect. The mean patient age was 59 years (range 32 to 84 years). All patients were available for short-term examination (≤3 months) and 54/75 patients for long-term follow-up evaluation (≥5 years, range 5 to 15 years) postoperatively. Clinical outcome was assessed using the disability scale of Aminoff and Logue.

Results: Lesion location included: 3/75 foramen magnum and cervical, 49/75 thoracic, 19/75 lumbar, 4/75 sacral. Complications associated with surgery were infrequent (3/75 wound healing disturbances, 1/75 spinal epidural haematoma, 1/75 subcutaneous accumulation of CSF). 5/75 patients required reoperation because of a residual and recanalized (4/75) or second fistula (1/75). In the early postoperative phase, 55/75 patients improved neurologically. The symptomatology in 18/75 patients remained unchanged, in 2/75 patients the symptoms deteriorated after surgery. 44/54 of the patients available for long-term follow-up remained improved (41/54) or stabilized (3/54), in 10/54 patients the symptomatology increased after surgery.

Conclusions: Microsurgical obliteration offered good and lasting results in 76% of the patients and therefore should be considered first line therapy for patients with Type I spinal AVM. Nevertheless, 24% of the patients showed an incomplete recovery or progressive functional decline in the postoperative period during the long-term follow-up. Therefore Type I spinal AVMs still represent a seriously disabling disease, which has to be considered when discussing the prognosis of Type I spinal AVMs. with patients.