Clinical analysis of 17 cases of spinal dural arteriovenous fistula

Abstract

Objective To review and analyze the clinical and imaging characteristics as well as the prognosis of patients with spinal dural arteriovenous fistula (SDAVF), in order to provide reference for the clinical diagnosis and treatment of SDAVF patients. Methods and Results A total of 17 patients with SDAVF diagnosed and treated at Tianjin Huanhu Hospital from May 2019 to January 2024 were included in this study. Among them, 15 patients presented with motor dysfunction, sensory impairment and autonomic dysfunction, while 2 patients presented with spontaneous subarachnoid hemorrhage. The lesions were located in thoracic vertebra in 12 cases, cervical vertebra in 3 cases, and lumbosacral vertebra in 2 cases. All patients underwent surgical resection of the SDAVF, and the operations were successfully completed. The follow⁃up time was (29.85 ± 19.09) months. At 7 d after surgery, the spinal cord function improved in 10 cases (including improvement in gait scores in 6 cases, bowel and bladder scores in one case, and both in 3 cases), while no improvement was observed in 7 cases. At the final follow⁃up, spinal cord function improved in 13 cases (including improvement in gait scores in 8 cases, and gait and bowel and bladder scores in 5 cases), while no improvement was observed in 4 cases. No recurrence was observed during the follow ⁃up period. Conclusions SDAVF predominantly occur in the thoracolumbar region of the spinal cord, with progressive symptoms mainly manifesting as motor dysfunction, sensory impairment and sphincter dysfunction. A small proportion of cases initially present with subarachnoid hemorrhage. The failure rate of surgical treatment is low, and the outcomes are significant. Early diagnosis can improve prognosis.

doi：10.3969/j.issn.1672⁃6731.2024.12.008