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64th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

26 - 29 May 2013, Düsseldorf

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Surgical treatment of spinal arteriovenous fistulae – management and outcome in a single-center series

Meeting Abstract

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  • Patrick Schuss - Klinik für Neurochirurgie, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn
  • Frederick H. Daher - Klinik für Neurochirurgie, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn
  • Horst Urbach - Klinik für Neuroradiologie, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn
  • Ági Oszvald - Klinik für Neurochirurgie, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn
  • Erdem Güresir - Klinik für Neurochirurgie, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn
  • Hartmut Vatter - Klinik für Neurochirurgie, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn

Deutsche Gesellschaft für Neurochirurgie. 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Düsseldorf, 26.-29.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocDI.11.10

doi: 10.3205/13dgnc273, urn:nbn:de:0183-13dgnc2730

Published: May 21, 2013

© 2013 Schuss 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

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Objective: Spinal dural arteriovenous fistulae (SDAVF) are the most common vascular malformations of the spine. SDAVF can be treated surgically, endovascularly or in a combined fashion. We analyzed our institutional database concerning surgically treated patients with SDAVF focusing on clinical characteristics, functional outcome and therapy management.

Method: From June 1990 to April 2012, 29 patients with SDAVF were treated in our institution. Patient characteristics, time from onset of symptoms to treatment, radiological features, anatomic characteristics of the feeding vessel, treatment-related complications, and functional outcome were analyzed. Outcome was assessed according to the Aminoff and Logue scale (ALS) at 6 months.

Results: Overall, 3 female (10%) and 26 male (90%) patients with SDAVF were treated surgically in our institution. Mean age was 61 ± 11 years. Location of the fistula was at thoracic level in 20 patients (69%), at lumbar level in 8 patients (28%) and at sacral level in 1 patient (3%). Mean postoperative ALS improved significantly after treatment compared to the preoperative status (p=0.02). In detail, 22 patients (76%) achieved improvement in neurological symptoms after surgical therapy. 6 patients (21%) demonstrated stabilization of preoperative neurological status, whereas 1 patient (3%) suffered from worsening. The mean follow-up was 50 ± 62 months. All SDAVF were treated within a single session without recurrence.

Conclusions: Surgical treatment of SDAVF is safe and effective and leads to an improvement of neurological symptoms in most patients.