Original scientific paper
https://doi.org/10.3325/cmj.2021.62.347
Spinal dural arteriovenous fistulas: a report on outcomes in a single-center retrospective cohort treated surgically and/or endovascularly
Miroslav Vukić
; Department of Neurosurgery, University Hospital Center Zagreb, Zagreb, Croatia
Hrvoje Barić
; Department of Neurosurgery, University Hospital Center Zagreb, Zagreb, Croatia
David Ozretić
; Zagreb University School of Medicine, Zagreb, Croatia
Ivan Jovanović
; Department of Neuroradiology, University Hospital Center Zagreb, Zagreb, Croatia
Zdravka Poljaković
; Zagreb University School of Medicine, Zagreb, Croatia
Katarina Tudor
; Department of Neurology, University Hospital Center Zagreb, Zagreb, Croatia
Krešimir Saša Đurić
; Department of Neurosurgery, University Hospital Center Zagreb, Zagreb, Croatia
Abstract
Aim To report on the outcomes of spinal dural arteriovenous fistulas (sDAVFs) treatment in a single-center retrospective cohort.
Methods Data were retrieved on sDAVF cases treated surgically and endovascularly between January 2009 and January 2020. Sociodemographic, clinical, imaging data, and
outcomes were analyzed.
Results Thirty-four patients were identified: 11 female,
mean age 64.1±11.5 years; mean time of symptom duration 12 (range 1-149) months. The sDAVF locations were
the following: 18 (62.1%) thoracic, 4 (13.8%) lumbar, 4
(13.8%) sacral, and 3 (10%) with multiple location feeders.
All patients had a motor deficit and affected walking, and
the majority had a sensory deficit, bowel, and bladder dysfunction. Fifteen (44.1%) patients underwent surgical treatment, 7 (20.6%) underwent endovascular treatment, and
12 (35.3%) underwent both (crossover). Radiological myelopathy showed regression in 19 (55.9%) patients. Overall,
clinical improvement (decrease in modified Rankin score)
following treatment was observed in 14 patients (41.2%),
worsening in 1 (2.9%), while other had unchanged status. The proportion of patients with initial treatment failure markedly differed between the before-2014 and after-2014 period. Patients who failed to improve had more
extensive myelopathy.
Conclusion Patients who underwent surgery or endovascular treatment had on average significant clinical recovery, while those who underwent treatment crossover had
negligible improvement. The extent of myelopathy seems
to be associated with clinical improvement
Keywords
Hrčak ID:
278441
URI
Publication date:
26.8.2021.
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