Spinal Dural Arteriovenous Fistulas: A Retrospective Analysis of Prognostic Factors and Long-Term Clinical Outcomes in the Light of the Recent Diagnostic and Technical Refinements.

Dural arteriovenous fistula Spinal vascular malformation Spine dAVF

Journal

Acta neurochirurgica. Supplement
ISSN: 0065-1419
Titre abrégé: Acta Neurochir Suppl
Pays: Austria
ID NLM: 100962752

Informations de publication

Date de publication:
2023
Historique:
medline: 28 12 2023
pubmed: 28 12 2023
entrez: 28 12 2023
Statut: ppublish

Résumé

Spinal dural arteriovenous fistulas (dAVFs) are abnormal connections between the meningeal branches of segmental arteries and a radiculomedullary veins that result in a progressive myelopathy thanks to perimedullary coronal venous plexus congestion. Usually, dAVFs show nonspecific symptoms, thus leading to late clinical suspicion and a difficult MRI diagnosis.Several authors have tried to identify prognostic factors before treatment, but published studies results are often inconsistent and sometimes contradictory.In this study, we reviewed our recent experience of 30 dAVF patients where we collected all demographic, clinical and angioarchitectural features as well as radiological and treatment-related characteristics. The thoracic spine was the most common location, constituting 53.3% of cases, followed by the lumbar roots, comprising 30%. About 83% of patients showed motor deficits, urinary disturbances were present in 70%, and bowel symptoms in 50%.We treated 86.7% of patients with microsurgery and 13.3% with endovascular occlusion with a mean interval between clinical onset and intervention of 10.8 ± 14.2 months.A significant clinical improvement was observed at follow-up in 80% of patients, with a significant reduction in mean G-score, U-score and F-score at a mean follow-up of 105.89 ± 191.9 months.However, none among the principal demographic, clinical and radiological characteristics showed significant prognostic value to the clinical improvement observed at follow-up.

Identifiants

pubmed: 38153474
doi: 10.1007/978-3-031-36084-8_35
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

223-230

Informations de copyright

© 2023. The Author(s), under exclusive license to Springer Nature Switzerland AG.

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Auteurs

Carmelo Lucio Sturiale (CL)

Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.

Anna Maria Auricchio (AM)

Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.

Iacopo Valente (I)

Department of Radiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.

Rosario Maugeri (R)

Neurosurgical Clinic, AOUP Paolo Giaccone, Department of Biomedicine Neurosciences and Advanced Diagnostics, School of Medicine, University of Palermo, Palermo, Italy.

Alessandro Pedicelli (A)

Department of Radiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.

Massimiliano Visocchi (M)

Institute of Neurosurgery, Catholic University of Rome, Rome, Italy.

Alessio Albanese (A)

Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.

Classifications MeSH