Surgical treatment of spinal dural arteriovenous fistulas

Abstract

92 patients with dural ateriovenous fistulas (AVF), been operated from 1998 to 2010, were under observation. Open microsurgical AVF switch-off was performed in all these patients. Before that AVF endovascular obliteration was used at 27 patients as an independent treatment method. However, because of AVF recurrence and neurologic symptoms progression patients were hospitalized for open microsurgical operation performing.To study treatment effectiveness we used the standardized assessment of neurological status before operation and before patient’s discharging from the hospital, and also in remote period (4–48 months later). After surgery a “significant improvement” was observed at 21 patients, “improvement” — at 62 patients, “no changes” — at 9, there was no neurological status worse. AVF treatment results depend on the completeness and adequacy of pathological anastomosis between feeding artery and drain vein switching-off that can be performed safely and radically only using microsurgical treatment.