Clinical Characteristics and Treatment Outcomes of Spinal Arteriovenous Malformations.

Abstract

Spinal arteriovenous malformations (SAVMs) are rare events. This study evaluated initial clinical presentations and treatment outcomes of SAVMs. In this study, 91 consecutive patients with SAVM between January 1993 and November 2014 were evaluated. Initial clinical presentations, radiological findings, treatment results, and follow-up outcomes were evaluated according to disease type and treatment modalities. Patient status was scored using the modified Rankin scale (mRS) and Aminoff-Logue Disability scale (ALS). Of the SAVM patients 69 % were male and 31 % were female with amean age of 49years (range 11-82years). At the time of initial imaging evaluation, myelopathy was the most common finding with main complaints of gait disturbance (69 out of 91, 76 %), sensory disturbances (61/91, 67 %), and bowel or bladder symptoms (51/91, 56 %). Among the 80patients who received treatment 56 (62 %) underwent endovascular embolization and 24 (26 %) underwent surgery. Complete obliteration was achieved in 47patients (84 %) after endovascular embolization and in 18 (75 %) after surgical ligation. At the time of final follow-up 67patients (84 %) showed improvement of more than 1point on the mRS, while 69 (86 %) showed significant improvement on the ALS after treatment. The SAVMs presented with diverse neurological deficits, including myelopathy. Endovascular or surgical treatment of SAVMs can result in good clinical outcomes in most patients.