An Acquired Cervical Dural Arteriovenous Fistula After Cervical Anterior Fusion: Case Report and Literature Review.

Anterior cervical discectomy and fusion (ACDF) Cervical anterior approach Late operative complication Postoperative DAVF Spinal dural arteriovenous fistula (DAVF) Spinal surgery

Journal

World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275

Informations de publication

Date de publication:
Aug 2019
Historique:
received: 24 02 2019
revised: 21 04 2019
accepted: 22 04 2019
pubmed: 6 5 2019
medline: 28 1 2020
entrez: 5 5 2019
Statut: ppublish

Résumé

Formation of a dural arteriovenous fistula (DAVF) after lumbar spine decompression in the lumbar spine has been reported as a late complication, but is extremely rare in the cervical spine. A 57-year-old man who underwent a C5-6, C6-7 anterior fusion 5 years previously for cervical myelopathy at another hospital presented with progressive gait disturbance and thermal hypoalgesia on the right side of the body. Magnetic resonance imaging showed flow voids in the spinal cord dorsally at the C4-7 level, which had not been detected before the initial operation. Digital subtraction angiography showed a fistulous connection at the C7 level between the perimedullary vein and a segmental artery from the right vertebral artery, which was diagnosed as a DAVF. Surgical interruption of the intradural draining vein with multilevel posterior cervical decompression was performed, and his symptoms improved. To the best of our knowledge, this is the first report of a DAVF developing after multilevel anterior cervical discectomy and fusion. All the published cases of secondary DAVF, especially after spinal surgery, are reviewed.

Sections du résumé

BACKGROUND BACKGROUND
Formation of a dural arteriovenous fistula (DAVF) after lumbar spine decompression in the lumbar spine has been reported as a late complication, but is extremely rare in the cervical spine.
CASE DESCRIPTION METHODS
A 57-year-old man who underwent a C5-6, C6-7 anterior fusion 5 years previously for cervical myelopathy at another hospital presented with progressive gait disturbance and thermal hypoalgesia on the right side of the body. Magnetic resonance imaging showed flow voids in the spinal cord dorsally at the C4-7 level, which had not been detected before the initial operation. Digital subtraction angiography showed a fistulous connection at the C7 level between the perimedullary vein and a segmental artery from the right vertebral artery, which was diagnosed as a DAVF. Surgical interruption of the intradural draining vein with multilevel posterior cervical decompression was performed, and his symptoms improved.
CONCLUSIONS CONCLUSIONS
To the best of our knowledge, this is the first report of a DAVF developing after multilevel anterior cervical discectomy and fusion. All the published cases of secondary DAVF, especially after spinal surgery, are reviewed.

Identifiants

pubmed: 31054344
pii: S1878-8750(19)31197-0
doi: 10.1016/j.wneu.2019.04.202
pii:
doi:

Types de publication

Case Reports Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

50-54

Informations de copyright

Copyright © 2019 Elsevier Inc. All rights reserved.

Auteurs

Ryo Kanematsu (R)

Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Shizuoka, Japan. Electronic address: ryo.knmt@gmail.com.

Junya Hanakita (J)

Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Shizuoka, Japan.

Toshiyuki Takahashi (T)

Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Shizuoka, Japan.

Yosuke Tomita (Y)

Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Shizuoka, Japan.

Manabu Minami (M)

Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Shizuoka, Japan.

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Classifications MeSH