Skip to main content
Log in

Surgical ligation of spinal dural arteriovenous fistula

  • How I Do it - Spine
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Abstract

Background

Spinal dural arteriovenous fistulas (SDAVFs) are abnormal arteriovenous shunts between a radicular artery and the radicular vein, located in the dorsal surface of the dura sleeve, which drains in a retrograde manner into the coronal venous plexus of the spinal cord without an interposed capillary network. This result is a venous hypertension that reduces spinal cord perfusion and leads to ischemia and edema. Spontaneous resolution is extremely rare and, once symptomatic, the typical course is further progression with increased neurological impairment. Therefore, once a fistula is diagnosed, treatment is recommended.

Method

The fistula is placed at the level of intervertebral foramen and surgical ligation is performed through a laminectomy. After dural opening, the area is inspected, and the arterialized vein is identified and ligated.

Conclusions

Laminectomy and arteriovenous fistula ligation is a safe and reliable approach for accessing and treating spinal dural arteriovenous fistulas.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Amanieu C, Hermier M, Peyron N, Chabrol A, Deiana G, Manera L (2014) Spinal dural arteriovenous fistula. Diagn Interv Imaging 95:897–902

    Article  CAS  PubMed  Google Scholar 

  2. Bortolotti C, Morales-Valero SF, Lanzino G (2014) Spinal dural arteriovenous fistulae. Contemp Neurosurg 36:1–5

    Article  Google Scholar 

  3. Krings T, Geibprasert S (2009) Spinal dural arteriovenous fistulas. AJNR Am J Neuroradiol 30:639–648

    Article  CAS  PubMed  Google Scholar 

  4. Marcus J, Schwarz J, Singh IP, Sigounas D, Knopman J, Gobin YP, Patsalides A (2013) Spinal dural arteriovenous fistulas: a review. Curr Atheroscler Rep 15:335

    Article  PubMed  Google Scholar 

  5. Saladino A, Atkinson JL, Rabinstein AA, Piepgras DG, Marsh WR, Krauss WE, Kaufmann TJ, Lanzino G (2010) Surgical treatment of spinal dural arteriovenous fistulae: a consecutive series of 154 patients. Neurosurgery 67:1350–1357 discussion 1357-1358

    Article  PubMed  Google Scholar 

  6. Steinmetz MP, Chow MM, Krishnaney AA, Andrews-Hinders D, Benzel EC, Masaryk TJ, Mayberg MR, Rasmussen PA (2004) Outcome after the treatment of spinal dural arteriovenous fistulae: a contemporary single-institution series and meta-analysis. Neurosurgery 55:77–87 discussion 87-78

    Article  PubMed  Google Scholar 

  7. Takai K, Komori T, Taniguchi M (2015) Microvascular anatomy of spinal dural arteriovenous fistulas: arteriovenous connections and their relationships with the dura mater. J Neurosurg Spine 23:526–533

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Giuseppe Lanzino.

Ethics declarations

Conflict of interest

None.

Informed consent was obtained for the procedure illustrated. However, no institutional review board approval, or patient consent is required per institutional policy for retrospective, single-cases in which no identifiable patient information is shared.

Electronic supplementary material

The authors demonstrate the steps for the successful access, cautery and division of a symptomatic spinal dural arteriovenous fistula in an 82-year-old man using a one-level laminectomy. (MP4 180,883 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sorenson, T., Giordan, E., Cannizzaro, D. et al. Surgical ligation of spinal dural arteriovenous fistula. Acta Neurochir 160, 191–194 (2018). https://doi.org/10.1007/s00701-017-3381-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-017-3381-z

Keywords

Navigation