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Clinical results after the multidisciplinary treatment of spinal arteriovenous fistulas

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Abstract

Purpose

We retrospectively evaluated the clinical outcome after multidisciplinary treatment of spinal arteriovenous fistulas (AVFs) in terms of the Aminoff-Logue grading scale (ALS) to depict the outcome in a perspective pertinent to the quality of everyday living.

Materials and methods

Twenty-six spinal AVFs in 25 patients were angiographically diagnosed from April 1998 through April 2012 and treated by endovascular embolization or surgery. When both treatment procedures seemed feasible, embolization was undertaken as the initial treatment. Motor and gait disturbance at follow-up was retrospectively graded according to ALS.

Results

All lesions were localized at the thoracolumbar or sacral levels and include six epidural AVFs with intradural venous reflux, 14 dural AVFs, and six perimedullary AVFs. Embolization was performed as the initial treatment for 17 lesions, while open surgery was performed for the others as well as for residual or recurrent lesions after embolization. All lesions were completely occluded except three perimedullary AVFs. At clinical follow-up of 1–153 months (mean 53.3), amelioration of gait disturbance with reduction of ALS scores was noted for 13 lesions and amelioration of micturition for 13 lesions as well.

Conclusion

Clinical functional status was improved for half of the lesions after the multidisciplinary treatment.

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Acknowledgments

Part of the study was presented at the 71st annual meeting of the Japan Radiological Society. We thank: Takeshi Asano, Department of Neurosurgery, Japanese Red Cross Asahikawa Hospital, Asahikawa, Japan; Tomohiko Hasegawa, Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan; Kazutoshi Hida, Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan; Koichi Hirano, Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan; Toru Hirano, Department of Orthopedic Surgery, Niigata University Medical and Dental Hospital, Niigata, Japan; Junji Nagano, Spine Center, Seirei Hamamatsu General Hosipital, Hamamatsu, Japan; Shigeru Nishizawa, Department of Neurosurgery, University of Occupational and Environmental Health, Kitakyushu, Japan; Takayuki Masui, Department of Radiology, Seirei Hamamatsu General Hosipital, Hamamatsu, Japan.

Conflict of interest

The authors declare that they have accepted no grants or have no conflict of interest pertinent to this study.

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Correspondence to Shoichi Inagawa.

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Inagawa, S., Yamashita, S., Hiramatsu, H. et al. Clinical results after the multidisciplinary treatment of spinal arteriovenous fistulas. Jpn J Radiol 31, 455–464 (2013). https://doi.org/10.1007/s11604-013-0216-6

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  • DOI: https://doi.org/10.1007/s11604-013-0216-6

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